アフタ様病変を伴った多発性単純性潰瘍の1例

Multiple Simple Ulcers Accompanied by Aphthoid Lesions, Report of a Case

要旨　患者は41歳，男性，検診の便潜血陽性の精査にて来院．大腸内視鏡検査で，上行結腸に多発する大きな潰瘍と潰瘍瘢痕を認め，腸結核を疑われた．約1年半後の大腸内視鏡検査で，上行結腸に深掘れの打ち抜き様潰瘍があり，回盲部にも小さい円形打ち抜き様潰瘍がみられた．全大腸にはアフタ様病変が散在していた．多発性の単純性潰瘍と診断して栄養療法を開始し，1か月後にはアフタ様病変は消失し，右側結腸の潰瘍は著明に縮小したが，2か月後には小腸にアフタ様病変が出現した．本症例はアフタ性口内炎がみられたものの，Behcet病の診断基準にみられる症状は出現せず，現時点では多発性の単純性潰瘍として経過観察中である．

　A 41-year-old man was found to be positive for fecal occult blood by the health care screening examination of his company, and visited our hospital. He had history of aphthoid stomatitis but no other signs of Behget's disease. Colonoscopic examination showed multiple, largeu lcer in the descending colon and many aphthoid lesions in the entire colon. Biopsy specimen obtained from ulcerative lesions showed non-specific inflammatory changes. Nutritional therapy and salicylazosulfapyridine cured these aphthoid lesions within one month.

　It is rare to find many aphthoid lesions of the entire colon in cases of simple ulcer.