偽膜性大腸炎の1例

Pseudomembranous Colitis, Report of a Case

　偽膜性大腸炎の1例を報告し，偽膜性大腸炎のX線ならびに内視鏡所見を中心に若干の考察を加える．

　A 69-year-old woman, suffering from aplastic anemia, liver cirrhosis and diabetes mellitus, was given in the course of treatment cefazolin (CEZ) and carbenicillin (CBPC). After 12 days she began to have abdominal pain and watery diarrhea. Endoscopic examination of the colon 13 day after she experienced diarrhea showed in the whole circumference of the rectum yellowish white elevations, uneven and irregular. From the sigmoid up to the descending colon were seen here and there hemispheric yellowish white protrusions. The mucosa around the elevations was generally normal. The biopsy specimens of the elevations histologically showed on the surface of the erosions mucus exudate and pseudomembrane consisting of necrotic tissue. Barium enema done almost at the same time revealed findings suggesting in parts shadow defects in addition to irregular margins. From the sigmoid to the transverse colon were seen here and there small, round radiolucencies, 0.5 to 0.8 cm in diameter. Antibiotics were discontinued and physiologic saline solution with steroid hormone was given daily once or twice as enema. After ten days diarrhea and abdominal pain became better. After one month the patient was free from any symptoms. X-ray and endoscopic examination was normal.

　Up to the psesent we have come across six cases of pseudomembranous colitis including the present one. We have gone into other cases in the findings of x-ray and endoscopy. In all cases the lesions centered on the rectum and the sigmoid. The lesions became more distinct and pseudomembrane became more dense and confluent, the more distal were the lesions.