術後10年余にわたり経過観察中の小腸Crohn病の1例

Crohn's Disease with Long Follow-up Study, Report of a Case

要旨　患者は37歳の男性で10年前に膀胱腸瘻の手術を受け，その原因が小腸Crohn病と診断された．術後5年で回腸に再発がみられ内科的治療を続け，更に5年経過した現在，自覚症状はほとんどない．回腸は狭小化が高度で内瘻も形成し回腸終末にはアフタ様潰瘍がみられ，胃前庭部にびらんを伴った小扁平隆起が数個みられたが，小腸，胃の生検では非乾酪性肉芽腫は認めていない．

　A 37 year-old man was diagnosed to have Crohn's disease after operation of a vesico-cervical fistula ten years ago. After five years from operation, recurrence was recognized in the ileum with cobblestone appearance, longitudinal ulcers. During five years after the recurrence, he take medicines and had no comlaint. But double contrast radiogram of the ileum showed stricture and longitudinal scar of the ulcer. Aphthoid ulcer in the terminal ileum and slight elevated lesions with erosion in the antrum were seen by endoscopic examination. In the microscopic findings of the ileum and stomach were not seen the epithelioid granuloma.