縦走潰瘍を呈したcollagenous colitisの1例

Collagenous Colitis with Longitudinal Ulcer, Report of a Case

要旨　患者は62歳，女性．1年2か月前に交通事故による頸椎症と診断されNSAIDsを内服していた．1年前から続く水様性下痢と突然の下血のため来院した．大腸内視鏡検査では，S状結腸に縦走潰瘍を認めた．生検組織では上皮下に肥厚したcollagen bandを認め，collagenous colitisと診断した．出血は1日で止まったが，頸椎症のためNSAIDs内服の中止は不可能であり水様性下痢は続いた．止痢剤では改善せずメサラジン内服にて治癒した．経過中一度メサラジンを中止したら，水様性下痢が再燃した．約1年間の投薬期間を要した．

　A 62-year-woman was admitted to our hospital with watery diarrhea for 1 year and the sudden onset of anal bleeding. She was diagnosed as cervicalis due to the traffic accident one year and two months previously, and had been taking NSAIDs. On colonoscopy, longitudinal ulcers were noted at the sigmoid colon. Multiple biopsy specimens showed thickened subepithelial collagen bands. She was disgnosed as having collagenous colitis. She was not able to stop taking NSAIDs because of the cervicalis. Although anal bleeding disappered in a day, watery diarrhea persisted. Mesalazine administration improved her symptom, but she could not stop taking Mesalazine. She was finally able to stop taking Mesalazine after a year of medication.