単純性潰瘍および腸型Behçet病のX線，内視鏡所見の検討―両者の病変分布，多発病変について

Comparison of Radiographic and Endoscopic Findings in Simple Ulcer and Intestinal Behçet's Disease―The Difference Between the GI Tract Lesions

　単純性潰瘍12例と腸型Behçet病6例のX線，内視鏡検査所見から両者の病変の分布および性状について検討し以下の結果を得た．①1例を除く17例が回盲部近傍に定型的病変を有していたが，腸型Behçet病の2例(33.3％)，単純性潰瘍の5例(41.7％)は回盲部以外にも病変を有していた．②回盲部以外に病変を認めたもののうち，腸型Behçet病では2例中1例，単純性潰瘍では5例中3例が上部消化管から大腸まで至る広範囲な病変を有していた．③回盲部以外の病変はアフタなどの小病変のみならず全例で透亮像を伴う類円形ないし不整形の明瞭な潰瘍性病変を有していた．④単純性潰瘍では，非定型的部位として十二指腸の下掘れ潰瘍，食道，直腸の打ち抜き潰瘍が1例ずつみられた．以上の結果から，単純性潰瘍も腸型Behçet病と同様に回盲部以外の病巣も多くみられ，さらに広範囲に多彩な病変を呈することが示唆された．

　To elucidate the morphological differences in the distribution of the lesions and in the nature of ulcers of intestinal Behçet's disease and simple ulcer, we analyzed X-ray and endoscopic pictures of six cases with intestinal Behçet's disease and twenty cases with simple ulcer. The results were summarized as follows.

1)All the seventeen cases except one intestinal Behçet's disease case had typical deep ulcers in the ileocecal region or the anastomotic site. Two cases with intestinal Behçet's disease (33.3 ％) and five cases with simple ulcer (41.7 ％) also revealed ulcerative lesions in another part of the ileocecal region.

2)In the 7 cases which had additional ulcerative lesions in another part of the ileocecal region, one case with intestinal Behçet's disease and three cases with simple ulcer revealed extensive multiple lesions from the upper to the lower GI tract.

3)The lesions in another part of the ileocecal region in seven cases, revealed not only small aphthoid ulcers but also well-demarcated round-shaped or irregulary- shaped ulcers.

4)Unusual GI tract involvement was recognized in two cases with simple ulcer. One case showed a punched-out ulcer in the esophagus and a typical deep ulcer in the duodenal bulb, while another case showed a punched-out ulcer in the lower segment of the rec-tum.

　These results suggested that simple ulcer patients, as well as intestinal Behçet's disease patients, have multiple, various-shaped ulcers in the whole segment of the GI tract.