盲腸に発生した非特異性結腸潰瘍の2例

Nonspecific Ulcer of the Colon: Report of Two Cases

　最近，筆者らは盲腸に発生し，手術によって治癒せしめえた非特異性結腸潰瘍の2例を経験したので，文献的考察を加えて報告する．

　Two cases of nonspecific ulcer of the cecum are reported.

　Case 1. A 36-year-old man was admitted because of diarrhea and lower abdominal pain. Barium enema showed filling defect in the cecum, thought to be a cancer crater, but cytologic examination using washing method failed to reveal cancer cells. Tuberculin reaction as well as Triboulet's reaction was positive. The WBC count was 9,200 and RSR was 44 mm in one hour. Colectomy was performed with clinical diagnosis of intestinal tuberculosis, revealing a sharply demarcated ulcer of the cecum 4.0×5.0 cm in size and 0.8 cm in depth. Histological examination of the resected specimen confirmed an isolated nonspecific ulcer of the colon.

　Case 2. A 14-year-old boy was admitted because of the passage of large amount of blood rectally. A tender mass was palpated in the right lower quadrant of the abdomen. Barium enema showed abscence of haustration, rigidity as well as granular mucosal pattern in the cecum. Fibercolonoscopic examination revealed cobblestone appearance and angiography showed inflammatory changes such as early staining of wall, avascular area, pooling and early venous return in the cecum. Tuberculin reaction was negative. The WBC count was 17,200 and RSR 39 mm in one hour. He continued to pass bloody stool and colectomy was performed with clinical diagnosis of granulomatous colitis, showing two sharply demarcated ulcers of the cecum 3.8×5.5 cm and 2.5×4.0 cm in size, respectively. Pathologic diagnosis was nonspecific ulcers of the colon.