細菌培養検査が陽性を示す虚血性腸炎様病変

Clinical Features of Culture-Positive Patients with Colonic Ischemia

要旨　過去11年間に大腸内視鏡検査を施行した全35,349例中，細菌培養検査以外の虚血性大腸炎の診断基準を満たした325例を対象として，培養陽性群と培養陰性群に大別し，臨床像，大腸内視鏡所見，および腸病変の経過を比較検討した．培養陽性群は56例（17.2％）で，腸管病原性大腸菌（enteropathogenic Escherichia coli ; EPEC）が検出菌の87.5％ を占めた．培養陽性群と培養陰性群で臨床症状，罹患部位，内視鏡所見，および臨床経過に差異は認めなかった．両者の鑑別は細菌学的検査を除けば困難であったことから，虚血性大腸炎様病変の病態に腸管感染症の関与が示唆された．

　To examine a possible role of bacterial pathogen in the pathogenesis of ischemic colitis, we reviewed cultures of feces and biopsy specimens in 325 patients with the colonoscopic diagnosis of ischemic colitis during the past 11-year period. Among those patients, bacterial cultures showed positive results in 56 patients, in 49 of whom the test results identified enteropathogenic There was no difference between the culture-positive group and the culture-negative group in clinical symptom, site of involvement, colonoscopic finding as subsequent clinical course. These findings suggest that bacterial infection may be involved in the pathogenesis of a certain proportion of clinically verified cases of ischemic colitis.