⑧回腸終末部に発生した非特異性多発性潰瘍の1例

A Case Report of Non-specific Ulcers of the Terminal Ileum

　臨床的に腸型Behçet病と思われる回腸終末部の非特異性多発性滑瘍を経験したので報告する．

症　例

　患　者：68歳　男性

　主　訴：下血

　家族歴：特記事項なし

　既往歴：22歳の時，虫垂切除術を受けた．また青年期より再発性の口腔アフタを認めており，数年前より肘，膝関節痛を訴えているほか，数力月前に陰囊部に難治性潰瘍を生じたことがある．

　A 68-year-old man was admitted to our hospital with complaint of melena. He had three main signs of Behçet's recurrent aphthous stomatitis, scrotum ulcer and iritis. Clinical examinations showed positive occult blood but no significant bacillus or virus was found. Barium enema study and colonoscopy revealed irregularly shaped multiple ulcers at the ileocecal valve and terminal ileum.

　Ileocecal resection was performed because of the recurrence of melena. The resected specimen demonstrated multiple skipped irregular ulcers and scars, measuring from 0.4-0.4 cm to 1.0-3.0 cm, at the terminal ileum and ileocecal valve. Ileal mucosa was diffusely edematous. Histologically, these ulcers and scars, undermining to submucosa, were of nonspecific inflammatory process. The base of the ulcers showed granulation tissues containing marked inflammatory cellular infiltration but no granulomas.

　Although the ulcers were not similar to those of Behçet's disease which has grossly undermined appearance, clinical symptoms of the patient suggested Behçet's disease. Therefore, this inflammatory changes were strongly felt to be the early stage of intestinal Behçet's disease.