胃十二指腸に限局したCrohn病の1例

Isolated Crohn's Disease of the Gastroduodenum, Report of a Case

要旨　患者は若年男性．貧血のため消化管精査目的に当院を受診した．上部消化管内視鏡にて胃角部前後壁に深掘れ線状潰瘍を認め，また幽門前庭に多発性びらん，十二指腸に巨大深掘れ潰瘍を認めた．生検組織診にて粘膜深部に強い炎症性細胞浸潤と非乾酪性類上皮細胞性肉芽腫を認め，小腸造影，ダブルバルーン小腸内視鏡および大腸内視鏡にて異常を認めないことより，胃十二指腸に限局したCrohn病と診断した．集学的治療にて保存的に緩解状態となり，経過観察中である．

　We report a case of isolated Crohn's disease in the gastroduodenum. A male teenager was hospitalized due to anemia. Endoscopic and double-contrast radiographic studies revealed deep and undermining ulceration in the gastric angle, multiple erosions in the gastric antrum, and deep, undermining and giant ulceration in the duodenum. Endoscopic biopsy revealed epithelioid granulomas without central caseation necrosis, probably indicating Crohn's disease. Double-contrast small intestinal barium study, double-balloon enteroscopy and colonoscopy revealed no abnormal findings, so we diagnosed the lesion as isolated Crohn's disease of the gastroduodenum. The patient was treated conservatively.