経過観察しえた虚血性大腸炎の1例

A One-year Follow-up Case of Ischemic Colitis

　下行結腸および横行結腸に線状潰瘍と著明なタッシェ形成，腸管の狭窄を来し，発症より1年余にわたって，経過を追求しえた1例を経験したので報告する．

　症　例

　患　者：79歳，男．

　主　訴：悪心，嘔吐，腹部膨満感，腹痛．

　家族歴：特記すべきことなし．

　既往歴：高血圧．

　現病歴：1年ぐらい前より，時々，腹部膨満感がみられたが放置していた．1979年9月初旬，食後に腹部膨満感が増強し，腹痛，嘔吐もみられ，某病院を受診し，浣腸の処置を行った．しかし，症状は軽快せず，水様性下痢が頻回となり，翌日には下血を認めるようになり，入院となる．症状は約1週間で消失したが，諸検査の結果，要精検のため，1979年9月下旬，当科入院した．

　The patient was a 79 year-old man with complaints of abdcminal pain, nausea, vomiting and fullness of the abdomen, and was radiographically followed up for a year.

　Radiographic findings of the colon on discovery showed linear ulcerative features of the transverse and descending colon of the mesenteric side, pseudodiverticula and strictures of the descending colon.

　Roentgenological examination of the colon two weeks later revealed partial strictures and pseudodiverticula in the middle portion of the transverse colon, increasing strictures and a number of the pseudodiverticula of various sizes in the descending colon.

　Two months later, x-ray survey was repeated. The findings of the descending colon remained unchanged. However, the strictures of the transverse colon tended to improve, and discontinuous cicatricial features of linear ulcers with convergent mucosal folds were delineated.

　Radiographic series one year after the onset showed stable findings of the transverse and descending colon.

　Characteristic features of ischemic colitis of this patient were linear ulcers, linear scars of the mesenteric side, marked pseudodiverticula and strictures. The aggravation or improvement of these changes of each part of the colon was also observed in a short period of time.