約3年半の経過でアフタから典型的な潰瘍性大腸炎へと進展した1例

Aphthoid Colitis as a Preceding Lesion of Ulcerative Colitis, Report of a Case

要旨　症例は60歳，男性．腹痛を主訴に当院へ入院した．急性膵炎の診断にて入院加療を行った．入院後，粘液，血液を混じる下痢が出現した．大腸内視鏡検査にて全大腸炎型の潰瘍性大腸炎（ulcerative colitis ; 以下UC）と診断した．UCおよびUCに合併した急性膵炎と診断し，ステロイドの投与を行い症状は軽快した．患者は以前より軟便傾向であり定期的に大腸内視鏡検査が施行されていたが，大腸内に散在するアフタのみの所見であった．急性膵炎の発症を契機に約3年半の経過でアフタから典型的な潰瘍性大腸炎へと進展した症例を経験したので，内視鏡像の経過を中心に報告する．

　A sixty-year-old man was admitted to our hospital with the complaint of abdominal pain. Treatment was carried out after a diagnosis of acute pancreatitis.

　After admission, diarrhea with mucous and blood appeared. He was diagnosed, by colonoscopy examination, as having ulcerative colitis (total colitis type). Steroid therapy was administrated and his clinical symptoms improved rapidly. Colonoscopy showed multiple aphthoid lesions before 40M. During 40M, the aphthoid colitis had progressed to typical ulcerative colitis. This case seems to be suggestive of the existence initial lesions and that progress the ulcerative colitis.