食道および小腸に所見を認め，長期経過観察が可能であった進行性全身性強皮症の1例

Long Time Follow-up of Progressive Systemic Sclerosis with Lesions of the Esophagus and the Small Intestine, Report of a Case

要旨　患者は53歳，男性．1969年に進行性全身性強皮症と診断された．それ以来，逆流性食道炎，および食道潰瘍による胸やけ・吐血を，また偽腸閉塞による上腹部痛，嘔気，嘔吐を再三起こし，入退院を繰り返している．食道X線検査，内視鏡検査で食道中部から下部にかけての拡張，凹凸不整な粘膜を認めた．十二指腸・小腸X線検査で十二指腸下行脚から水平脚にかけての拡張を，空腸上部に狭窄と拡張を認めた．7年後の再検では，十二指腸の拡張に変化はみられなかったが，空腸には所見を認めなかった．本症例のX線所見について若干の文献的考察を加えて報告した．

　A 53-year-old man was diagnosed as having progressive systemic sclerosis in 1969. Since then, he has been admitted to our hospital time and time again with complaints of heart burn, hematoemesis caused by reflux esophagitis and esophageal ulcer, and upper abdominal pain, nausea, vomiting caused by pseudoileus of the small intestine. Radiographic and endoscopic examination (Fig. 1, 2a, 2b) revealed dilatation, irregular mucosa and ulcer in the middle and lower esophagus. Radiographic examination (Fig. 3a, 3b) revealed dilatation in the descending and transverse portion of the duodenum, stenosis and dilatation in the upper part of the jejunum. Reexamination after 7 years (Fig. 4a, 4b) showed dilatation of the duodenum, but no changes in the upper part of the jejunum. We report the radiological changes of the esophagus, duodenum and jejunum of the patient suffering from progressive systemic sclerosis and disscussed it.