大腸結核のX線および内視鏡診断

X-ray and Endoscopic Diagnosis of Colonic Tuberculosis

要旨　大腸結核症例のうち活動期病変を有する16例のX線および内視鏡所見について検討した．活動期の潰瘍の形態は，不整びらん型88％，輪状型69％，不整型63％，アフタ様びらん型44％などが観察された．活動期病変を有する場合でも周辺に瘢痕萎縮帯や炎症性ポリープ，腸管の短縮，回盲弁の開大などを伴うものが多い．非活動期では多発潰瘍瘢痕，偽憩室，回盲弁の開大などが特徴的であった．活動期病変で結核菌が証明されたものは16例中8例（50％）で生検組織の培養が有用であり，肉芽腫は5例（31％）に証明された．腸結核のX線および内視鏡診断は，主病変のみならず周辺に結核の特徴を見出すことが大切である．

　Radiologic and endoscopic study of colonic tuberculosis was made, based on 16 cases of active tuberculosis of the colon and 59 cases of inactive tuberculosis. The incidence of ulcer types was observed as follows; irregular erosive type (88%), circular type (69%), irregular ulcer type (63%), and aphthoid erosive type (44%). The active lesions were frequently associated with inactive lesions such as inflammatory polyps, scarred area with discoloration, shortening of the colon and Bauhin's valve insufficiency. The lesions were mostly located in the right-sided colon. The characteristics of inactive lesions were shown to be multicentric ulcer scars, sacculations and Bauhin's insufficiency. Mycobacterium tuberculosis was detected in 8 out of 16 patients by culture of biopsy specimens, and granuloma was demonstrated in 5 out of 16 patients.

　It is conculuded that in X-ray or endoscopic diagnosis of colonic tuberculosis it is important to observe the associated lesions as well as main lesions.