{"created":"2023-06-19T10:30:55.114721+00:00","id":3071,"links":{},"metadata":{"_buckets":{"deposit":"2bc309de-5967-470b-b5f2-d944a85c18b5"},"_deposit":{"created_by":31,"id":"3071","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"3071"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00003071","sets":["1709617079800:35:808"]},"author_link":["131362","131363","131364","131365","131366","131367","131368","131369","131370","131371","131372","131373","131374","131375","131376","131377","131378","131379","131380","131381","131382","131383","131384","131385"],"item_10001_alternative_title_1":{"attribute_name":"その他(別言語等)のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"A dialysis patient with multiple intestinal diverticula in whom partial penetration was recognized.","subitem_alternative_title_language":"en"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"25","bibliographicPageStart":"17","bibliographicVolumeNumber":"48","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_10001_description_33":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"症例報告","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_10001_description_34":{"attribute_name":"記事種別(英)","attribute_value_mlt":[{"subitem_description":"Case Report","subitem_description_language":"en","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"川崎医学会","subitem_publisher_language":"ja"}]},"item_10001_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.11482/KMJ-J202248017","subitem_relation_type_select":"DOI"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://igakkai.kms-igakkai.com/wp/wp-content/uploads/2022/KMJ-J202248017.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN12940574","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2758-089X","subitem_source_identifier_type":"EISSN"}]},"item_10001_text_31":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学検査診断学（内視鏡・超音波）"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学検査診断学（内視鏡・超音波）"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学総合外科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学病理学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学総合外科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学総合外科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学検査診断学（内視鏡・超音波）"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学総合外科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学検査診断学（内視鏡・超音波）"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学検査診断学（内視鏡・超音波）"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学総合内科学２"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学総合外科学"}]},"item_10001_text_32":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Endoscopy and Ultrasound"},{"subitem_text_language":"en","subitem_text_value":"Department of Endoscopy and Ultrasound"},{"subitem_text_language":"en","subitem_text_value":"Department of General Surgery"},{"subitem_text_language":"en","subitem_text_value":" Department of Pathology"},{"subitem_text_language":"en","subitem_text_value":"Department of General Surgery"},{"subitem_text_language":"en","subitem_text_value":"Department of General Surgery"},{"subitem_text_language":"en","subitem_text_value":"Department of Endoscopy and Ultrasound"},{"subitem_text_language":"en","subitem_text_value":"Department of General Surgery"},{"subitem_text_language":"en","subitem_text_value":"Department of Endoscopy and Ultrasound"},{"subitem_text_language":"en","subitem_text_value":"Department of Endoscopy and Ultrasound"},{"subitem_text_language":"en","subitem_text_value":"Department of General Internal Medicine 2, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of General Surgery"}]},"item_10001_textarea_5":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"　Jejunal diverticula (JD) are considered to be rare and are asymptomatic in most cases. However, they are potentially associated with serious complications, such as diverticulitis and perforation/penetration, especially in the elderly. In the event of perforation/ penetration, JD usually penetrates the mesentery, resulting in the formation of an abscess in the mesentery, which is difficult to diagnose, because there are no specific signs. Anion exchange resin agents, such as sevelamer hydrochloride (SH), are often used for hyperphosphatemia in dialysis patients, but the package insert cautions against the development of the adverse effect of gastrointestinal perforation. Herein, we report a case in which abdominal ultrasonography (US) was useful for the diagnosis of jejunal diverticular penetration in a hemodialysis patient. The patient was a male in his 70s who had been on hemodialysis for 18 years and was receiving SH 2.25g/day. He presented to a neighborhood hospital with a 10-days’history of fever. The fever did not improve with conservative therapy, and the patient was referred to our hospital. Physical examination revealed mild epigastric tenderness, but there were no signs of peritoneal irritation. Computed tomography (CT) was performed, and the presence of free air was suspected. Abdominal US performed subsequently showed multiple jejunal diverticula and abscess formation around the diverticulum. Furthermore, free air was recognized in the abscess, which was finally diagnosed as a mesenteric abscess complicating JD penetration. On the same day, jejunal resection was performed and histopathological examination of the surgical specimen revealed findings consistent with the US findings. Histopathology revealed sevelamer crystals in the penetrated diverticulum. US is useful for the diagnosis of penetration of JD in dialysis patients."}]},"item_10001_textarea_6":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"　小腸憩室は比較的稀な疾患で，多くが無症状で経過するが，穿孔した場合は腸間膜内に穿通し膿瘍形成をきたす．高齢者に多く，その診断および治療の遅れから重篤な経過をたどることも少なくない．その診断にはコンピュータ断層撮影（CT）が有用とされているが，穿孔部位や憩室の特定は困難とされ，術前に指摘できるものは決して多くない．透析患者では高リン血症に対し陰イオン交換樹脂剤などが一般的に使用されるが，消化管穿孔の注意が記載されている．今回我々は，透析患者の腸管穿孔の原因検索に体外式超音波（US）が有用であった１例を経験したので，文献的考察を含めて報告する．症例は70歳台男性，18年前から血液透析を行っている．10日前に発熱で近医を受診し，保存的に経過を見ていたが炎症反応の上昇を認め当院紹介受診した．身体所見は心窩部付近に軽度の圧痛を認めたが腹膜刺激兆候は明らかでなかった．単純 CT で消化管外の free air が疑われ，精査目的に US が行われた．US では空腸に多発している憩室と，憩室周囲の膿瘍形成およびその内部の free air と思われる点状高エコーが認められ，小腸憩室穿通と診断した．同日小腸切除術が行われ，病理組織学的検索の結果，US と同様の所見であった．また穿通した憩室にセベラマー結節が認められ，憩室穿通に関与した可能性が示唆された．US は透析患者における憩室穿通の診断に有用である．"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"中藤, 流以","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"眞部, 紀明","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"石田, 尚正","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"物部, 泰昌","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松原, 正樹","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"浦上, 淳","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"藤田, 穣","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山辻, 知樹","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"今村, 祐志","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"畠, 二郎","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"春間, 賢","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"猶本, 良夫","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NAKATO, Rui","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MANABE, Noriaki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"ISHIDA, Naomasa","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MONOBE, Yasumasa","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MATSUBARA, Masaki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"URAKAMI, Atsushi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"FUJITA, Minoru","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YAMATSUJI, Tomoki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"IMAMURA, Hiroshi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"HATA, Jiro","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"HARUMA, Ken","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NAOMOTO, Yoshio","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2023-03-10"}],"displaytype":"detail","filename":"KMJ-J202248017.pdf","filesize":[{"value":"5.2 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/3071/files/KMJ-J202248017.pdf"},"version_id":"5d81b3b3-b957-4301-9d2a-118437c6a051"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"小腸憩室","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"透析","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"消化管穿孔","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"陰イオン交換樹脂","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"セベラマー塩酸塩","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Intestinal diverticula","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Dialysis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Penetration","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Anion exchange resin agents","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Sevelamer hydrochloride","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal 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