アフタ様病変のみから比較的短期間に典型像に進展したCrohn病の1例

Crohn's Disease Presenting Progression from Solely Aphthoid Lesions to Longitudinal Ulcers, Report of a Case

要旨　患者は17歳，女性．軟便を主訴として来院．消化管検査で胃から大腸までアフタ様病変が散在，特に大腸のアフタ様病変は縦走に配列していた．胃前庭部からの生検で非乾酪性類上皮肉芽腫を認め，アフタ様病変のみのCrohn病と診断した．その後，自然に症状は軽快したため来院せず，約10か月後に軟便を自覚して来院．消化管検査の結果，大腸のアフタ様病変は増加し，上行結腸およびS状結腸に縦走潰瘍を認めた．約8週間の経腸栄養療法で自覚症状は消失し，X線および内視鏡上縦走潰瘍の瘢痕化とアフタ様病変の減少が確認された．

　At the initial examinations of the gastrointestinal tract, a 17-year-old woman with the complaint of soft stool was found to have only aphthoid lesions in the stomach, duodenum, small intestine and colon. Histological examination of the biopsy specimens from the antrum showed non-caseating epithelioid cell granulomas. She was diagnosed as having Crohn's disease. Ten months later, barium enema and colonoscopy revealed longitudinal ulcers in the ascending and sigmoid colon. These were successfully treated, using nutritional means.

　Further studies are necessary to clarify whether nutritional treatment in the early stage of Crohn's disease may prevent the progression of this disease.