12.腸型Behҫet病・単純性潰瘍

Rectal Bleeding in Postoperative Recurrent Ulcers of Intestinal Behҫet's Disease and Simple Ulcer

要旨　腸型Behҫet病（BD）・単純性潰瘍（SU）で臨床症状を術後再発例からみると，腹痛が63％に対して出血は20％であった．出血例は吻合部に多発潰瘍が認められた．出血早期では浮腫状粘膜に打ち抜き様潰瘍がみられ，次に不整形潰瘍になり，次いで潰瘍が明瞭となった．しかし，BD・SUでみられる典型的な潰瘍に比べて潰瘍辺縁の炎症性の盛り上がりは軽度であった．治療としては無水エタノール1回の撒布により止血できたが，潰瘍を瘢痕化するためには複数回の撒布が必要であった．

　The postoperative recurrence of intestinal Behҫet's disease and simple ulcer is frequently noticed. We have studied the chief complaints in postoperative recurrent ulcers. Rectal bleeding accounts for 20 ％ of the chief complaints in postoperative recurrent ulcers. Recurrent ulcers have been recognized around the anastomotic region. The ulcers with rectal bleeding were smaller than those with abdominal pain. Patients with rectal bleeding were found to have no inflammatory reaction in WBC or CRP. We have performed spraying for recurrent ulcers with absolute ethanol. In the initial period the punched out ulcers around the anatomotic area were recognized. After ethanol spraying during the initial period the ulcers became irregular in shape and, under this method of therapy the size of recurrent ulcers decreased or they were sometimes reduced to scars.