STDによる腸炎の画像診断

Diagnostic Imaging for Enterocolitis Caused by Sexually Transmitted Disease (STD)

要旨　STDによる腸炎として，アメーバ性大腸炎，AIDSに合併した大腸炎，クラミジア腸炎の画像診断について述べた．アメーバ性大腸炎ではたこいぼ所見が診断価値の最も高い所見であった．AIDSに合併したサイトメガロウイルス腸炎の2例を呈示した．1例は周囲に発赤を伴う大小様々な打ち抜き様潰瘍がみられた．他の1例はやや盛り上がったびらん，発赤を中心とした病変であった．クラミジア腸炎の2例を呈示した．1例は直腸のリンパ濾胞の著明な増生がみられた．他の1例は直腸・S状結腸と回盲部のアフタ様びらんがみられた．アメーバ性大腸炎の内視鏡診断は既に確立しているが，その他のSTDによる腸炎の画像診断についてはわが国での経験は非常に少なく，今後症例を集積して，画像診断を確立する必要があると考えられた．

　In amebic colitis, observation of a varioliform elevated lesion was the most important finding for diagnosis. Two cases of AIDS complicated by cytomegarovirus colitis were presented. One case showed many punched-out ulcers, large and small, together with rubor in the surrounding area. The other case showed a slightly elevated lesion with erosion and rubor. Two cases of Chlamydia trachomatis colitis were presented. Marked lymphoid hyperplasia was found in the rectum in one case. A resion consisting mainly of aphthous erosions in the rectosigmoid and ileocecal region was found in the other.

　Although endoscopic diagnosis for amebic colitis has already been established, cases of diagnostic imaging of other types of enterocolitis caused by STD are very few in Japan. Further cases should be studied and data accumulated for establishing diagnostic imaging for this disease.