Yersinia enterocoliticaによる急性回腸末端炎の2例

Acute Terminal Ileitis due to Yersinia Enterocolitis Infection, Report of Two Cases

　Yersinia enterocolitica（以下 Y. e.）による腸管感染症は，1964年のCarlssonらの報告以来，急性回腸末端炎の原因として注目され，最近本邦でもその報告が散見されるようになった．しかしながら，本邦ではそのX線所見について詳細に述べているものは少なく，また回腸末端部の内視鏡所見についての報告は，欧米を含めても見当たらない．今回われわれは，内視鏡検査までしえたY．eによると考えられる急性回腸末端炎を2例経験したので報告し，主としてそのX線・内視鏡所見について考察を加えた．

　Two cases of acute terminal ileitis examined by x-ray and endoscopy are reported here due to Yersinia enterocolitica.

　The patient No. 1 is a 32 year-old woman complaining of diarrhea, abdominal cramp and fever. She was admitted to the hospital. Both x-ray and endoscopic examination of the terminal part of the ileum showed varioliform elevated lesions with reddening, coarse mucosa and edema. The same elevated lesions were also seen in numbers in the ascending colon. By the culture of the feces Yersinia enterocolitica was isolated. The antibody titer of the serum rose up to 160×.

　The patient No. 2, a 56 year-old woman, was admitted to the hospital with complaints of fever and abdominal pain. X-ray and endoscopic examination revealed edema, ulcer formation, and varioliform elevations. In the appendix were also the same varioliform multiple elevations. The titer of antibody in the serum rose up to 80×.

　1. This is the first report of endoscopic examination of the terminal ileum in this disease.

　2. X-ray and endoscopic examination of the terminal ileum in this disease showed over the mucosa edema, ulcer formation, coarse surface, reddening and varioliform elevated lesions.

　3. Lesions of this disease were seen as varioliform elevations not only on the terminal ileum but on the caecum and ascending colon as well.

　4. Histological picture of the biopsy specimens consisted mainly of inflammatory infiltration of mostly of lymphocytes. Varioliform elevations in this disease suggest prominent infiltration of lymphocytes and erosions in the center.