腸型Behçet病と単純性潰瘍の長期予後―術後再発

Endoscopic Therapy with Absolute Ethanol for Postoperative Recurrent Ulcers in Intestinal Behçet's Disease and Simple Ulcer

　腸型Behçet病・単純性潰瘍は大きく深い潰瘍を形成するために外科的手術が行われる．しかし，吻合部近傍に潰瘍再発が約70％みられた．術後再発例では発症後に大きな潰瘍形成により再手術となる例が多い．そこで，術後早期に内視鏡検査を行うと，そのときに潰瘍が再発した場合でも小さな潰瘍であることが多いので，無水エタノールを撒布することで潰瘍の縮小ないし瘢痕化が期待できる．この治療により再手術例は今のところない．術後再発例に無水エタノール撒布による内視鏡治療は試みられて良い．

　When examined macroscopically and histologically, there are no differences between “simple” intestinal ulcers and intestinal ulcers of Behçet's disease.

　The postoperative recurrence of intestinal Behçet's disease and simple ulcers is frequently noticed. Medical treatment for postoperative recurrent ulcers is palliative, and the patient often requires surgery. We investigated the effect of absolute ethanol spraying via endoscopy for these ulcers. Postoperative recurrence was 69 ％ (11/16). Commonly, the ulcer recurred around the anastomotic region. We performed spraying for recurrent ulcers with absolute ethanol in 5 patients. This therapy was effective for the recurrent ulcers in all 5 patients. In this study, the patients who were monitored and treated by the spraying of ethanol did not require further surgery. This therapy should be performed for recurrent ulceration in cases of both simple ulcers and intestinal ulcers of Behçet's disease.