6）病原性大腸菌腸炎

Diarrhoginic E. coli Associated Enterocolitis

要旨　病原性大腸菌は5群に分類されている．なかでも腸管出血性大腸菌による腸炎は腹痛，下痢，血便，平熱あるいは微熱が特徴的である．溶血性尿毒症症候群を合併することがあり，早期診断が重要となる．内視鏡所見は直腸から盲腸までの連続性病変であり，右側結腸ほど病変が強度となる．全周性の発赤，びらん，浮腫が著明である．その他の病原性大腸菌による出血性腸炎の内視鏡所見は左側大腸型と右側大腸型の2群に分かれた．症例数は左側結腸型が12例中10例と多かった．左側結腸型の内視鏡所見は縦走性びらんや浮腫であり，典型的な虚血性大腸炎と鑑別困難であった．

　Entrohemorrhagic E. coli (EHEC), one of the five groups of diarrhrogenic E. coli-associated enterocolitis is characterized by abdominal cramps, bloody diarrhea and no or low-grade fever. The colitis, causes hemolytic uremic syndrome so it should be diagnosed as early as possibile. Characteristic endoscopic findings are: an extended lesion from the rectum to the cecum, with the lesion more severe on the right side colon. It also shows marked redness, erosion and edema.

　Our endoscopic findings of the other groups of enterocolitis (non EHEC colitis) were divided into two types, the left-side colon type and the right-side colon types. Of the 12 cases, the number of left-side types was 10. The endoscopic findings of the left-side type were longitudinal erosion and edema, but, by these findings alone, it was impossible to differentiate this type of enterocolitis from typical ischemic colitis.