内視鏡的粘膜切除術（EMR）で治療しえた盲腸angiodysplasiaの1例

Cecal Angiodysplasia Successfully Treated with Endoscopic Mucosal Resection: Report of a Case and a Review of the Japanese Literature

要旨　種々の循環器系基礎疾患を有する高齢者に繰り返す下血と貧血が出現し，大腸内視鏡検査および出血シンチグラフィにて盲腸angiodysplasiaからの出血が示唆された．血管造影や超音波内視鏡では異常が捉えられず同部位に限局した小病変と考え，内視鏡的粘膜切除術を施行し，病理所見でngiodysplasiaであることを確認した．術後経過も良好で，1年3か月経過した現在も再出血を認めていない．消化管出血の原因としての大腸angiodysplasiaの重要性，その治療方針などを含め文献的考察を加えて報告する．

　A 75-year-old man was admitted to our hospital because of recurrent rectal bleeding and severe anemia. Colonoscopy disclosed a red spot in the cecum, measuring approximately 5 mm in size. Superior and inferior mesenteric arteriograms and endosonography did not reveal any abnormal findings. Under a diagnosis of bleeding cecal angiodysplasia, endoscopic mucosal resection was performed. Microscopic examination of the resected specimen confirmed the diagnosis. Follow-up during the following 15 months has been uneventful. Detailed information on this case and a review of 69 Japanese cases of colonic angiodysplasia during the last 10 years has been provided.