3) 腸管Behcet病・単純性潰瘍

Endoscopic Therapy for Postoperative Recurrent Ulcers in Intestinal Behcet's Disease and Simple Ulcers

要旨　腸管Behcet病（BD）・単純性潰瘍（SU）は術後に約70％再発した．再発例に臨床症状が出現した場合，吻合部に大きな潰瘍を形成し，再手術になった．手術例では早期に大腸内視鏡で吻合部を検索し，小潰瘍であれば，無水エタノール撒布やPentasa^®注腸液撒布により潰瘍は縮小または瘢痕化する．無水エタノールは大きな潰瘍では腹痛などの症状が出るので，Pentasa^®撒布が有用である．また，回腸に潰瘍が多発した症例ではPentasa^®注腸液は100mlあるので病変部に薬剤が行きわたることが推測できる．現在ではPentasa^®注腸液による治療を主に行っている．

　The postoperative recurrence of intestinal Behcet's and simple ulcer is frequently noticed. Recurrent ulcers have been recognized around the anastomotic region. We performed spraying for recurrent ulcers with absolute ethanol, but the patient complained of abdominal pain after we used it for spraying big ulcers. For that reason, we have used mesalazine fluid for such spraying. The patient has not complained of abdominal pain due to mesalazine spraying. In the initial period punched out ulcers around the anastomotic region were recognized. Under these therapies the size of the ulcers has decreased or were sometimes reduced to scars.