@article{oai:ir.kagoshima-u.ac.jp:00014466,
 author = {林, 知実 and 横山, 憲三 and 東, 泰志 and 天辰, 仁彦 and 浦田, 正和 and 夏越, 祥次},
 issue = {1-3},
 journal = {鹿児島大学医学雑誌, Medical journal of Kagoshima University},
 month = {Dec},
 note = {症例は65歳、男性。心窩部痛、嘔気を主訴に受診。軽度炎症反応の上昇を認めたが腹膜刺激症状はなかった。造影CT検査で右側結腸軸捻転による絞扼性イレウスが疑われ緊急手術を施行した。術中所見は黄色漿液性腹水が貯留し、右側結腸が結腸間膜を中心に360度時計周りに捻転していた。整復後の腸管色調は良好であったが、右側結腸の浮腫、拡張が著明であったため、右半結腸切除術を施行した。術後経過は良好で術後 2 週間で退院した。結腸軸捻転症はADLの低下した高齢者に多く、病状の進行が急速で予後不良になる場合がある。結腸軸捻転症の術前診断は困難とされているが、自験例でも造影CT検査で腸間膜軸捻転に伴うwhirl signや右側結腸の拡張を確認し、腸管虚血が進行する前に手術を施行できた。CT検査は多方面からの撮影が可能であり、結腸軸捻転症の診断に有用である。, A 65-year-old man was admitted to our hospital because of abdominal pain and nausea. Peritoneal irritation symptoms were not apparent, only mild inflammatory responses were observed in blood tests. However, since strangulation ileus by the right colon volvulus was suspected by contrast-enhanced CT, surgery was performed urgently. Yellow serous ascites and right colon twisted at 360 degrees clockwise around the mesocolon were found intraoperatively. Although intestinal color after reduction was not so bad, right hemicolectomy was performed due to marked edema and extension of the right colon. The postoperative course was good and he was discharged two weeks after surgery. Colon volvulus commonly occurs in the elderly patients with poor activities of daily living（ADL）and some patients have poor clinical outcome due to rapid exacerbation. Although preoperative diagnosis of colon volvulus is often difficult, we could do surgery by confirming the extension of the right colon and whirl sign by CT. CT examination in multiple planes is useful for diagnosis of right colon volvulus.},
 pages = {1--5},
 title = {絞扼性イレウスの診断に腹部CT が有用であった右側結腸軸捻転症の1例},
 volume = {70},
 year = {2018}
}