高齢者を主とする連続500剖検例の消化管病変―隆起性病変を中心として

Localized Lesions of the Digestive Canal in 500 Serial Cases of Mostly Old Japanese Autopsied at an Internal and Psychiatric Hospital: With special reference to elevated lesions

　消化管疾患は診断と治療の進歩に伴って，大都市の総合病院では早期に発見され，全治する患者が激増している．一方，これらの病院には選択された患者が集中する傾向にあり，その疾患の発生頻度は統計的に高くなるであろう．したがって，地方に取り残された老人を主として診療している病院において剖検された症例から，良性隆起性病変を中心に消化管病変の発生頻度を調査しようと試みた．

　このような見地から，福岡県の旧筑豊炭田地区にあり，内科・精神科の診療を行なっている鞍手共立病院を選び，最近約9年間になされた連続500剖検例について，消化管の局在病変を検索したので報告する．

　This is a statistical investigation of localized Lesions of the digestive canal in serial 500 autopsy cases for the past 9 years in Kurate Kyoritsu Hospital, rural district, Fukuoka, Japan. Autopsy ratio for the dead was 76% in this hospital. The autopsy was mostly performed within 6 hrs post mortem. These cases, 283 males and 217 females, had been mostly admitted by psychiatric troubles.

　The localized lesions were 249 in total, i.e. 85 benign tumors, 127 benign ulcers and 37 cancers. The benign tumors were composed of 31 adenomatous polyps, 37 hyperplastic polyps, 5 heterotopic pancreata, 5 lipomas, 4 angiomas and 3 leiomyomas.

　The epithelial polyps contained 30 sessile and 38 pedunculated ones. The former were common in the stomach and the latter in the large intestine. Adenomatous polyps and adenocarcinomas were most frequent in the stomach and in the large intestine. Polyps were more extensive than cancers.

　The incidence of adenomatous polyps and of cancers in these cases is less frequent than that examined by Arminski et al. in the United States and more often than in the study done by Bremner et al. in the South African Bantu.