腸型Behçet病とsimple ulcerの臨床経過―疾病史からみた腸型Behçet病とsimple ulcerの異同

Clinical Picture and Course of Behçet's Disease and Simple Ulcer: Concerning the Difference Between the Disorders

要旨　単純性潰瘍と腸型Behçet病，そして完全型Behçet症候群の異同について検討する目的で，疾病史としての立場からこれらの疾患患者の臨床経過を検討した．有症状期に全消化管のX線または内視鏡検査を行い，潰瘍性病変の有無を検索した結果，単純性潰瘍では病変部位は回盲部，切除例では吻合部近傍であることが多かった．腸型Behçet病では回盲部に下掘れ潰瘍が発生したが，食道以外のすべての消化管にも，一過性であるにせよ，小びらん，アフタ様潰瘍が散在することが多かった．Behçet症候群では十二指腸や空腸に小びらんがみられたが，回盲部には病変はみられず，各疾患で病変範囲に若干の差があった．単純性潰瘍と腸型Behçet病の臨床症状を解析した結果，完全型Behçet症候群としての症状が後日になって発現したことはなく，各疾患間の移行は確認されなかった．したがって現段階では各々の疾患は同一疾患であるとする証拠はみられなかった．

　To elucidate the differences among simple ulcer, intestlnal Behçet and complete Behçet's syndrome, the clinical pictures and courses were compared. The whole gastrointestinal tract was examined by x-ray and/or endoscopy during symptomatic phase to reveal the distribution of gastrointestinal tract involvement. In simple ulcer, ulcerative lesions were often observed in the ileocecal region, and around the stoma in operated cases. In intestinal Behçet, undermining ulcers were observed in the ileocecal region. However, small erosions and aphthoid ulcers were, even if transient, often observed in the gastrointestinal tract other than the esophagus. In complete Behçet's syndrome, small erosions were observed in the duodenum and jejunum. However, ulcerative lesions were not observed in the ileocecal region.

　During the long-term follow-up of the cases with simple ulcer and intestinal Behçet, complete Behçet's syndrome was not manifested in any case. Transition between the three entities was not observed. Accordingly, the theory cannot be supported that the three disorders are the same.