腸型Behcet病の1例―特にそのマイクロアンギオグラフィー所見について

Intestinal Behcet's Disease, a Case Report: With special reference to the microangiograms of the resected specimen

　Behcet病に潰瘍性消化管病変が合併するいわゆる腸型Behcet病が近年注目され，その報告例も急増している．この潰瘍性病変は急速に増悪し，容易に穿孔するので報告された手術例の60％以上は緊急手術例である．最近われわれは2年4カ月の経過観察の後，待期的手術を施行した腸型Behcet病の1例を経験した．組織学的には血管病変が重要視されているが，新たな知見が得られることを期待して，切除標本にマイクロアンギオグラフィーを施行した．その結果，腸型Behcet病の再発に関して興味ある知見を得ることができたので報告する．

　We recently experienced an operative case of Behcet's disease of intestinal type. The patient was a 32-year-old woman. She was found to have a large open ulcer (Ul-Ⅳ) of the cecum measuring 11×2cm and 3 ulcer scars (Ul-Ⅲ) in the ileum near the Bauhin's valve, for which she underwent right hemicolectomy. Microangiography could successfully be performed on the excised intestinal segment. The tissue surrounding the open ulcer of the cecum was hypervascular in contrast to the base of the ulcer which was markedly hypovascular. On the other hand, localized hypovascularity was noted at the ileal ulcer scars in spite of a complete healing of the lesions. These findings permit to speculate that when and if ischemia occurs in the neighborhood of such a scar, the affected area becomes locus minoris resistentiae and, accordingly, vulnerable to recurrence of ulcer and eventually perforation.