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要旨 friable mucosa,granular mucosa,multiple aphthaeの内視鏡所見がみられる潰瘍性大腸炎(ulcerative colitis;UC)関連胃十二指腸炎(gastroduodenitis associated with UC;GDUC)の頻度,特徴,経過,治療について調べた.UC患者280例中(全大腸炎型180例,大腸全摘術後175例)24例(8.6%)にGDUCがみられ,その特徴は,病勢の強い全大腸炎型で,ステロイド投与量が少なく,術後症例においては回腸囊炎の合併が多かった.再度内視鏡検査が行われたGDUC陰性43例のうち,平均22か月の観察で2例(4.7%)に新たなGDUCの発生を認めた.GDUCの治療は粉砕化メサラジンを用い,7例中5例で寛解が得られた.合計26人のGDUC症例中2例で出血による貧血を来し,2例で十二指腸に狭窄がみられた.初期病変はmultiple aphthaeと考えられた.
Friable and granular mucosa, and multiple aphthae were identified as characteristic findings of gastroduodenitis associated with ulcerative colitis(GDUC)in our previous study. These endoscopic findings were observed in 24(8.6%)of 280 patients with ulcerative colitis(180 with pancolitis, 175 with colectomy). Seven GDUC patients were treated with powdered mesalazine(crushed tablets), and the remission of GDUC was achieved in 5 of the 7 patients. Repeat upper endoscopy was performed for 43 GDUC-negative patients. The development of GDUC was observed in 2(4.7%)patients 22 months on average after initial endoscopy. In a total of 26 GDUC patients, 2 patients had anemia due to duodenal bleeding on friable mucosa, and 2 had duodenal stenosis as a result of chronic inflammation on friable mucosa. These results suggest that GDUC is not a rare complication and is a condition that requires therapy.
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