⑤X線検査で術前に診断しえた非特異性腸潰瘍の1例

Nonspecific Ulcer of the Colon; Report of a Case Which Was Correctly Diagnosed Radiologically before the Operation

　癌研病院で1905年1月から1978年12月までに手術によって確認されたいわゆる単純性非特異性腸潰瘍は5例9病変である．そのうち術前にX線検査で非特異性潰瘍と診断できた1例を報告する．

症　例

　患　者：37歳　男性　建築業

　主　訴：右下腹部痛

　既往歴：35歳時虫垂切徐．36歳時腹壁ヘルニアの手術をうけ限局性腸炎の診断をうけている．

　現病歴：1976年7月25日午後より腹部膨満感が生じ，数日後より右下腹部に約5分間隔で数秒間の激痛を感ずるようになり，同時に同部位の鶏卵大の腫瘤に気付いた．8月4日鹿児島市立病院消化器内科受診．注腸X線険査の結果，盲腸に数コの憩室および回腸終末部の潰瘍性病変を指摘され入院した．

　A 37-year-old male patient was admitted with a complaint of the right lower abdominal pain. X-ray examination of the upper gastrointestinal tract did not detect any abnormalities in the esophagus, the stomach, and duodenal intestine. Barium meal method showed irregular niches in the cecum and ileum. Compression method revealed the niches with fold convergence better than the filling method.

　Colonoscopy showed a deep ulcer with a white coating in the cecum but an ulcer of the ileum was not detected. The clinical diagnosis of multiple nonspecific ulcers of the ileum and cecum was performed by X-ray and colonoscopic examinations.

　A resected specimen revealed two deep ulcers in the cecum and ileum measuring 2.2×2.5 cm and 2.0×1.5 cm respectively.

　From our findings we concluded that nonspecific ulcers can be distinguished from diseases such as Behçets disease, Crohn's disease, colonic tuberculosis and cancer of the large bowel by using a combination of X-ray examinations, clinical findings, endoscopy and angiography.