潰瘍性大腸炎における虫垂病変の臨床的特徴

Clinical Characteristics in Ulcerative Colitis Endoscopically Showing a Skip Lesion at the Appendix

要旨　最近の4年4か月間に当院でtotal colonoscopyを施行した，初発または再燃例で治療前の活動期潰瘍性大腸炎の中で虫垂開口部に非連続性病変がみられた症例を選び出し，性別，年齢，病型，病変部位，炎症反応，重症度，治療効果，治療後の経過などについて検討した．虫垂開口部に非連続性病変がみられたのは11例であった．これらには共通した臨床的特徴がみられた．すなわち主病変部位が直腸を含む下部大腸に多く，初回発作型が多く，全例軽症であり，salicylazosulfapyridineによる治療に対する反応がよいことであった．今後，虫垂部の非連続性病変の意義を解明することが潰瘍性大腸炎の病態の解明に寄与する可能性が考えられた．

　Among the patients initial or recurrent active ulcerative colitis given total colonoscopy in the past four years and four months at our hospital, we selected those who had skip lesions in the mouth of the appendix before treatment and examined sex, age, disease type, site of lesion, inflammatory reaction, severity, therapeutic effects and post-treatment course. We explained characteristic endoscopic findings in particular. Discontinuous lesions at the mouth of the appendix were found in eleven patients. They had common clinical features; the major lesion was present mostly in the lower part of the large bowel including the rectum, many of the patients suffered initial and acute occurrence, all of them were mild and responded satisfactorily to the treatment with salicylazosulfapyridine. It was considered that understanding of the significance of a skip lesion in the appendix would contribute to the elucidation of the pathogenesis of ulcerative colitis.