S状結腸多発憩室症と大腸癌の合併

Complication of Colonic Carcinoma in Multiple Diverticulosis Involved in the Sigmoid Colon

　大腸憩室症は，本邦では比較的稀な疾患と考えられていたが，最近では諸家の報告にみるように増加傾向にある．われわれの集計でも大腸憩室症の頻度は年々増加しており，欧米に多いとされる左側大腸憩室も稀ならず認められるようになった．

　臨床的には憩室炎による出血あるいは穿孔，大腸癌の合併など重要性を増している．

　408 cases of colonic diverticula were found in the barium-enema examinations carried out on 6,067 cases during the past seven years. The right half of the colon has been thought to be most frequently involved in Japan, but the diverticula in the left half of the colon have often been observed since the barium-enema examination, especially the double contrast examination.

　31 cases of multiple diverticulosis, which consist of more than ten diverticula in the sigmoid colon, were investigated to evaluate the relationship between the multiple diverticulosis in the sigmoid colon and the colonic carcinoma.

　Multiple diverticulosis in the sigmoid colon complicated colonic carcinoma in 8 of 31 cases (25.8％), 4 of which were sigmoid carcinoma and the rest were rectal.

　In 2,000 series of barium-enema examination in our hospital 125 cases (6.3％) were diagnosed as the colonic carcinoma which consist of 87 in rectum, 23 in the sigmoid colon, and 15 in the remaining area of the colon.

　This fact showed that the incidence of the complication of the colonic carcinoma in the multiple diverticulosis in the sigmoid colon was significantly high.

　Melena was the chief complaint in 11 cases of the multiple diverticulosis studied here and was found due to the colonic carcinoma in 7 of them. This suggests thst the barium-enema examination should be carefully carried out to confirm the presence of the colonic carcinoma when the multiple diverticulosis in the sigmoid colon are present.