スキルス胃癌と鑑別を要する非腫瘍性疾患―急性胃炎

Acute Gastritis

要旨　急性胃炎は，急激に発症する，各種の原因によって生じる胃粘膜の急性炎症である．その画像診断と組織学的診断の間に乖離が存在することが多く，注意が必要である．原因の多くは薬剤やアルコールなどであるが，H. pylori初感染やCMV感染などの関与も念頭に置く必要がある．画像的特徴として，著明な粘膜の発赤，浮腫が主所見である．時に出血斑や粘膜の皺襞の著明な腫大が認められる．スキルス胃癌との重要な鑑別点は，腫大した皺襞が軟らかく，空気量で変化することである．急性胃炎の治療は，原因または誘引の除去が基本となる．症状あるいは所見の強い症例に対しては，薬物療法が行われる．

　Acute gastritis is a sudden inflammation of the mucous of the stomach, and has many causes. It is necessary to note that a difference of diagnosis often exists between diagnostic imaging and histological diagnosis. The main causes are excessive alcohol consumption or the use of drugs including NSAIDs. It is necessary to investigate also the participation of such agents as primary H. pylori infection and CMV（cytomegalovirus）infection. The characteristics of endoscopic findings or X-ray examinations are reddish color and edema of the gastric mucoca. Additionally, hemorrhagic spots and giant fold of the mucous membrane is recognized. An important differential point from scirrhous gastric cancer is the softening of the gastric mucosa, by changing the air content. As for the treatment of the acute gastritis, the removal of the cause is basic. Drug therapy is carried out in cases with strong symptoms, and endoscopic or X-ray examinations are made to check on the symptoms.