感染性腸炎の内視鏡所見

Endoscopic Study of Infectious Enteritis

要旨　感染性腸炎132例の急性期の大腸内視鏡所見を検討した．キャンピロバクター腸炎では全大腸に発赤，びらんを散在性に認めることが多く，Bauhin弁上の潰瘍は高率にみられた．腸炎ビブリオ腸炎では大腸の罹患率は低く，Bauhin弁の腫大，びらん，終末回腸のびらんが高率にみられた．サルモネラ腸炎では直腸，下行結腸の罹患率は低く，散在する発赤，びらんが高率にみられた．エロモナス腸炎はS状結腸，ブドウ球菌腸炎は左側大腸に好発し，ともに内視鏡像に一定の傾向はなかった．びまん性，縦走性，アフタ性病変など他疾患と鑑別を要する病変もしばしばみられ，診断には便培養が必要であるが，罹患部位と内視鏡像の特徴からある程度の診断は推定できた．また，炎症性腸疾患に合併した例の診断にも多くは有用であった．

　We studied endoscopic findings of 132 cases of infectious acute stage enteritis observed by colonoscopy. In patients of Campylobacter enteritis we often recognized scattered redness and erosion in the whole large intestine, and ulcer on Bauhin's valve. In patients with Salmonella enteritis the morbidity was low in the rectum and descending colon and scattered lesions were often recognized. In patients with Aeromonas enteritis the morbidity was high in the sigmoid colon, and in patients with Staphylococcal enteritis the morbidity was high in the left-side large intestine, but specific endoscopic pictures were not seen in either type. In diffuse, longitudinal and aphthoid lesions the differentiation from other diseases was needed, and stool culture is inevitable for diagnosis of infectious enteritis. However, to some degree, endoscopic examination is useful for diagnosis in infectious enteritis and also in cases complicated by inflammatory bowel disease.