急性胆嚢炎で発症し術前にDICとなった胆嚢腺扁平上皮癌の1例

We report a case of resected adonosquamous carcinoma of the gallbladder with acute cholecystitis and preoperative DIC. A 79-year-old woman was admitted to our hospital because of acute cholecystitis due to cystic duct obstruction by carcinoma of the gallbladder. There were high fever and henns ‘egg-sized tumor with severe tenderness on the right hypochondrium. Based on various examinations, a diagnosis advanced crcinoma of the gallbladder (Hinf3) was determined. Until the operation, because of exacerbation of acute cholecystitis, DIC occurred. The day before operation, percutaneus transhepatic gallbladder drainage was done. Then partial liver segmentectomy (S4a and S5) with cholecystectomy was carried out. Direct infiltration to the liver was observed. Histopathologically, the gallbladder tumor was adenosquamous carcinoma. After the operation, she recovered from DIC. But metastatic lymphnodes around common bile duct were enlarged rapidly, and obstructive jaundice appeared. On 55th day after the operation, she died because of peritonitis carcinomatosa 55 postoperative days. It was considered that preoperative acute cholecystitis, DIC and postoperative obstructive jaundice resulted from rapid growth of adenosquamous carcinoma.

著者英表記誤記あり(誤）Nagamitsu Shinohara→（正）Hisamitsu Shinohara