上部消化管内視鏡にて“竹の節状外観”を呈した全大腸炎型潰瘍性大腸炎の1例

Ulcerative Colitis Complicated by Endoscopical “Bamboo Appearance”, Report of a Case

要旨　患者は36歳，女性．23歳ごろより軽度の下痢，軟便を認めていた．35歳時下痢に続いて下血を認め全大腸炎型潰瘍性大腸炎と診断された．5-ASA，5-ASA注腸にて治療開始するも高熱，高炎症反応にて治療に難渋し，入院後抗菌薬と顆粒球除去療法にて症状は軽快し緩解した．その後外来にて緩解維持していたが上腹部痛を訴えたため，上部消化管内視鏡検査を施行しCrohn病に特有のいわゆる“竹の節状外観”を認めた．今回IBD（inflammatory bowel disease）の胃病変に関して文献的考察とCrohn病の自験例を踏まえて報告する．

　We report a case of a 36-year-old female with ulcerative colitis with endoscopical “bamboo appearance”.

　At the age of 23, she developed diarrhea. At the age of 35, she developed diarrhea and hematomasis. A diagnosis of ulcerative colitis was made by endoscopic examination. Thereafter she received 5-ASA and 5-ASA-enema. However, hospitalization was required. G-CAP therapy was successful and the desease remitted. As an outpatient, she experienced upper abdominal pain, esophago-gastro-duodenoscopy revealed the so-called “bamboo appearance” peculiar to Crohn's desease.