潰瘍性大腸炎における非典型的所見―区域性病変

Segmental Distribution of Inflammatory Change of Ulcerative Colitis

要旨　潰瘍性大腸炎の経過で直腸に明らかな病変を認めず，他の領域に病変を認める例を区域性とした．この区域性の分布をみる潰瘍性大腸炎20例から臨床所見・X線所見の特徴を求めた．臨床的特徴は全結腸炎型，再燃緩解型に多かった．区域性病変は2領域以上になると，下血・粘液便などをみた．1領域では臨床症状をみなかった．区域性の病変は下行結腸から横行結腸にかけて多く，炎症性所見は3型ないし4型であった．この区域性病変が治癒すると腸壁の変形・炎症性ポリープが認められた．これらの変化をみるのにX線検査は有用であった．

　We have defined the segmental distribution of inflammatory change (segmental change) of ulcerative colitis (UC) as UC without an active inflammatory lesion in the rectum. We have experienced 20 cases with segmental change out of 163 cases with UC during the period between 1972 and 1997. As for the anatomic distribution of segmental change, 70％ of the cases with segmental change had lesions from the descending colon to the transverse colon. Although cases with two segmental lesions had symptoms of rectal bleeding and diarrhea, cases with single segmental lesion did not complain of above symptoms. Radiologically, most of the cases with segmental change were classified as type 3 and/or 4 inflammation. Segmental change was healed with inflammatory polyps. Radiological examination disclosed inflammatory changes of segmental lesions of UC effectively.