大腸Crohn病の非定型例―その頻度と臨床像

Atypical Cases of Crohn's Colitis: Frequency and Clinical Pictures

要旨　大腸Crohn病の非定型例を，敷石像も縦走潰瘍も有しない症例と定義して，その頻度と臨床像を検討した．当科初診時，非切除大腸Crohn病29例中5例（17％）が非定型例と判断された．これらは，①種々の形態の潰瘍から成る症例，②区域性びまん性病変，③自然緩解を呈する症例，であった．Crohn病にみられる潰瘍の形態や緩解像のスペクトルを十分に経験すると共に，特殊な経過を示す症例の存在を知っていれば，非定型例といえども積極診断は可能と思われる．

　The frequency and the clinical pictures of atypical cases with Crohn's colitis were studied. The atypical case of Crohn's colitis was defined as a case with neither cobblestone appearance nor longitudinal ulcers more than 5 cm in length. In 29 non-operated Crohn's colitis patients at the initial visit, 5 cases (17%) were diagnosed with atypical cases. They were characterized as follows: 1) aggregation of various shaped-ulcers, 2) segmental lesions with diffuse inflammation, 3) spontaneous remission. It would be necessary for diagnosing atypical Crohn's colitis to experience a wide spectrum of ulcers and remission of the Crohn's disease and to know the existence of cases with unusual clinical courses.