特徴的な内視鏡像を呈した里吉症候群の1例

Satoyoshi Syndrome with Characteristic Endoscopic Findings, Report of a Case

要旨●患者は20歳代，女性．食思不振と腹痛を主訴に当科へ紹介され受診となった．前医にて十二指腸狭窄を指摘されていた．上部消化管内視鏡検査では胃体部を中心に著明な萎縮粘膜を認め，多数の囊胞様隆起と色素沈着を伴っていた．十二指腸にはKerckring皺襞の消失を伴う粗糙粘膜と撒布性白斑を認めた．生検は病理組織学的にgastroenterocolitis cystica polyposaの所見を呈していた．筆者らは，既往歴が明らかでなかった時点で，その特徴的な内視鏡・病理所見から里吉症候群と診断することができた．里吉症候群は原因不明の非常にまれな疾患であるため，適切な診断と治療のために知見を集積することは重要と考えられる．上部消化管内視鏡検査の通常観察と生検は，本症の特徴的な所見を得るのに有用であった．

　A 2X-year-old woman was referred to our hospital with complaints of appetite loss and abdominal pain. She was previously diagnosed with duodenal stenosis. EGD（Esophagogastroduodenoscopy）revealed severe atrophic mucosa with multiple cystic protrusions and pigmentations mainly in the body of the stomach as well as the elimination of Kerckring folds, with roughened mucosa and disseminated white spots in the duodenum. The patient was diagnosed with Satoyoshi syndrome based on the characteristic EGD findings, although her past history was unclear.

　Because Satoyoshi syndrome is an extremely rare disease with unknown etiology, it is important to accumulate knowledge for its diagnosis and treatment. Conventional EGD is valuable for identifying the characteristic features of this disease.