わが国における大腸憩室症（大腸憩室疾患）の実態――とくに発生頻度と臨床像について―

The Epidemiology and the Clinical Features of the Diverticular Disease of the Colon in Japan

　大腸憩室症（大腸憩室疾患）は最近わが国でもかなりの頻度で発見されており，憩室炎や出血などの合併症も必ずしも稀ではない．今回は1977年度に発足した厚生省特定疾患・特発性腸管障害調査研究班の大腸憩室疾患分科会（以下研究班），およびこれに引続き行った検討および調査結果を中心にして，本邦における本症の実態について述べたいと思う．

　Among 21,030 cases of lower G. I. series, which were performed at 6 different institutions, diverticular disease of the colon was found in 5.5%, and age distribution of the incidence showed gradual increment by aging-namely from 3.6% in less than 29 years old to 8.7% in more than 70 years old.

　Sex difference showed that male (7.7%) was dominant than female (3.6%) and this difference was more prominent among the younger age.

　Analyzing the total cases of diverticular disease, 75% was located at the right side of the colon, 11% located bilaterally and 14% was located at the left side of the colon. In younger age, the right sided diverticular disease was 90% but in age of more than 70 years old, right sided type was 42%, bilateral type was 18% and left sided type was 40%.

　Regarding number of the diverticulum, solitary one was 27%, diverticula ranging from 2 to 9 was 54%, more than 10 diverticula was 19% and the number of the diverticulum increased by aging and this phenomenon was more prominent in the left sided diverticular disease.

　On the incidence of the diverticular disease, there were significant difference among the six institutions and we could devide following 3 different areas. Namely, area with high incidence (Tokyo, Hyogo, Fukuoka) where the incidence was more than 10% in the 40～60 year-old groups, area with low incidence (Aomori) where the incidence was less than 5% among the all different age groups and area with intermediate incidence (Niigata and Kasumigaura). Comparing to Aomori area, Tokyo area showed, 4 folds of incidence among the all different age groups.

　Analyzing symptoms of 638 cases of diverticular disease, abdominal pain was seen in 40%, abdominal symptoms other than pain were in 15%, merely abnormal bowel movement was 12 %, other G. I. symptoms were in 12% and the rest of 21% was asymptomatic. Concerning bowel movement, normal bowel movement was seen in 55%, diarrhea was in 27%, constipation was in 12% and 6% had constipation alternated by diarrhea. Both symptoms and bowel habits of the diverticular disease showed no significant difference by their location.

　Among the 633 cases, definite and probable diverticulitis and its history was seen in 3.6%, diverticular bleeding was seen in 1.1%. These complications were most frequently seen in the left sided type, then bilateral type and less seen in the right sided type.