Abstract
症例は61歳男性．発熱と右下腹部痛を主訴に当院を受診．右下腹部に限局した圧痛，反跳痛を伴う腫瘤を触知し，血液検査では，炎症反応の上昇を認めた．CT検査で回盲部に限局した低吸収性の腫瘤を認め，虫垂の同定は困難であった．膿瘍形成性虫垂炎，限局性腹膜炎と診断し，保存的治療後切除の方針とした．入院後抗菌薬投与で，腹部症状，炎症所見の改善を認め，CTでも腫瘤の縮小を認め退院した．２カ月後のCTで回盲部の腫瘤は残存し，下部消化管内視鏡検査で虫垂開口部に隆起を認め，虫垂腫瘍を疑い手術した．腫瘤は回腸，盲腸に固着し，腹腔鏡下回盲部切除を施行．術後病理診断は虫垂粘液囊腫の穿孔で，粘液囊胞腺腫であった．虫垂粘液囊腫の穿孔は，膿瘍形成性虫垂炎との鑑別は困難であるが，保存的治療後も腫瘤が残存する場合は，積極的に切除すべきである．今回自験例も含め，腹腔鏡手術を施行した虫垂粘液囊腫の本邦報告例149例を検討した．
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