大腸憩室に多発炎症性ポリープと潰瘍性大腸炎様所見（diverticular colitis）を伴った1例

A Case with Colonic Diverticula Complicated by Multiple Inflammatory Polyps and Ulcerative Colitis-like Lesions（diverticular colitis）

要旨　63歳，男性が下腹部痛と血便を主訴に来院した．注腸X線検査で多発性大腸憩室とともにS状結腸の狭小化，多発する透亮像がみられた．大腸内視鏡検査では狭小化したS状結腸に発赤した多発ポリープがみられ，さらに口側のS状結腸には潰瘍性大腸炎に類似した点状びらん（小黄色斑）が多発していた．ポリープは組織学的に過形成性変化が主体であったが，粘膜脱症候群と類似していた．多発びらんの領域よりの生検ではびまん性の非特異的慢性炎症像がみられ，直腸が組織学的に正常であることから，diverticular colitisと診断した．diverticular colitisと潰瘍性大腸炎との異同については今後検討が必要であるが，当面このような病変の存在を認識することが重要である．

　A-63-year old man visited our hospital complaining of lower abdominal pain and hematochezia. Barium enema X-ray demonstrated multiple colonic diverticula and narrowing of the sigmoid colon with multiple filling defects. Colonoscopy revealed multiple reddish polyps in the narrowed portion and minute erosions similar to those observed in ulcerative colitis（UC）segmentally distributed on the oral side of the sigmoid colon. Histologically, the polyps were hyperplastic in nature and the features of mucosal prolapse syndrome were also observed. Diffuse, nonspecific inflammatory changes were observed in the biopsy specimens from the area of minute erosions ; rectal biopsy was normal and the diagnosis of“diverticular colitis”was made. The distinction between diverticular colitis and UC is unclear at present, however, it is important to recognize the presence of such lesions.