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要旨 腸管Behçet病・単純性潰瘍15例におけるカプセル内視鏡とバルーン内視鏡内視鏡所見を遡及的に検討し,不全型Behçet病(DBD),Behçet疑い(SBD),狭義の単純性潰瘍(non-BD)で比較した.15例中5例で回盲部より口側の小腸病変が認められ,その所見は多発潰瘍(5例),アフタ様病変(1例),敷石様所見(1例)に大別された.病型別に検討すると,DBD・SBD 11例中4例(36%)に小腸病変が認められ,2例(18%)ではアフタ様病変あるいは敷石様所見が認められた.一方,non-BD 4例中1例(25%)にのみ小腸の多発潰瘍が認められた.15例中,小腸と結腸・直腸のいずれかに病変が認められたのは10例であったが,両部位が罹患したのはnon-BDの1例のみであった.以上より,腸管Behçet病・単純性潰瘍では小腸病変が少なくないこと,および両疾患における回盲部以外の病変の性状が異なる可能性が示唆された.
We reviewed enteroscopic findings in 15 patients with intestinal Behçet's disease or simple ulcer of the small intestine, and compared the findings among patients with DBD(definite Behçet's disease), those with SBD(suspected Behçet's disease)and those with simple ulcer of the small intestine(non-BD). Either capsule endoscopy or balloon-assisted endoscopy identified ileal lesions in 5 patients. The enteroscopic findings included multiple ulcers(5 patients), aphthous ulcers(1 patient)and cobblestone-like appearance(1 patient). 4 of 11 patients with DBD or SBD had ileal lesions, 2 of whom had aphthous lesions or cobblestone-like appearance. In contrast, ileal lesions were found in only 1 of 4 patients with non-BD. While either ileal or colorectal lesions were found in 10 of 15 patients, only one patient with non-BD had both ileal and colonic lesions. These observations suggest that ileal lesions are not infrequent in patients with intestinal Behçet disease or simple ulcer of the small intestine, and that the ileal and that colorectal lesions are different between the 2 diseases.
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