感染性腸炎と潰瘍性大腸炎の比較―特に臨床像と内視鏡像を中心にして

Infectious Enteritis and Ulcerative Colitis: Mainly concerning the clinical and endoscopic picture

　感染性腸炎と潰瘍性大腸炎の臨床的鑑別は，必ずしも容易ではない．われわれは，本誌9巻5号で感染性腸炎の内視鏡像について報告したが，最近潰瘍性大腸炎16例を経験し，両疾患群の臨床像および内視鏡像にっいて比較検討する機会を得たので報告する．

　It is not always easy to differentiate clinically ulcerative colitis from infectious colitis. During the past 2 years clinical and endoscopic studies were carried out in Tokyo Metropolitan Toshima Hospital of 10 cases of bacillary dysentery, 16 of salmonella enteritis, 7 of vibrio enteritis and 16 of ulcerative colitis-mainly rectosigmoid type.

　Clinical features:

　Many cases of infectious enteritis had high fever over 38℃, while in ulcerative colitis the body temperature was either normal or at most lower than 38℃. Symptoms of gastroenteritis such as nausea and vomiting were characteristic of salmonella enteritis and vibrio enteritis.

　Mucosanguineous diarrhea was common in both types of enteritis and ulcerative colitis, though in the latter there were a few cases that showed mucosanguineous stool but no diarrhea. Regarding crisis and aggravating phase, infectious enteritis mostly occurred in summer, while ulcerative colitis was seen in all seasons. Clinical symptoms of infectious enteritis did not persist over three months.

　Endoscopic pictures:

　In ulcerative colitis endoscopic pictures consisted of marked damage in comparison with its clinical pictures, while in infectious enteritis we have never found chronic inflammatory changes and pseudopolyposis.

　In histologic pictures we were unable to notice specific changes other than generally inflammatory findings in both diseases. Crypt abscess was found more often in ulcerative colitis than in infectious enteritis.

　Minute observation of clinical findings would suffice for the differentiation between infectious enteritis and ulcerative colitis except for some sever type of the latter. Stool culture must be repeated in cases where ulcerative colitis is suspected.