竹の節状外観を呈したCrohn病の1例

Crohn's Disease with Bamboo Joint-like Appearance, Report of a Case

要旨　症例は28歳，男性．17歳時より痔核を認め，腹痛，体重減少，軟便を主訴に紹介受診となった．入院後，大腸内視鏡検査，注腸X線検査で小腸大腸型Crohn病と診断された．同時期に行った上部消化管内視鏡検査で，胃体部小彎側を中心に腫大した粘膜ひだに沿って垂直方向への切れ込み像，いわゆる“竹の節状外観”を認めた．経腸栄養療法で緩解となった．その後，主病変は緩解再燃を繰り返すも，胃病変に変化は認められなかった．比較的典型的な“竹の節状外観”を呈した症例を経験したので，内視鏡所見を中心に報告する．

　A twenty-eight-year old man was admitted to our hospital with the complications of abdominal pain, weight loss and loose passage. He had hemorrhoids at the age of seventeen. After hospitalization, he was diagnosed as intestinum tenue large bowel type Crohn's disease by colonoscopy, enema X-ray examination. It was found, by endoscopy, to have a “bamboo joint-like appearance” with swollen longitudinal folds transversed by erosive fissures. Treatment was carried out after the diagnosis of Crohn's disease. The clinical symptoms disappeared with nutrition therapy. As for the main lesion, even though there were temporary remittences there was recrudescence and no change was recognized in the lesion in his stomach. Because we encountered the case as presenting comparatively typical “bamboo joint-like appearance”, we reported it mainly according to endoscopic findings.