十二指腸非乳頭部びまん性病変─IBDの十二指腸病変

Duodenal Lesions in Patients with Inflammatory Bowel Diseases

要旨●上部消化管内視鏡検査を施行した自験Crohn病，潰瘍性大腸炎，腸管Behçet病における十二指腸病変を遡及的に解析した．Crohn病62例における十二指腸病変の陽性率は48%であり，ノッチ様陥凹を11例（18%）に，アフタ様びらんを21例（34%）に，数珠状粘膜を2例（3%）に，明らかな潰瘍を4例（6%）に認めた．治療介入の有無で比較したところ，アフタ様びらんの頻度が治療介入例で非介入例よりも有意に高かった．一方，潰瘍性大腸炎および腸管Behçet病の十二指腸病変の出現率はそれぞれ1.3%および13%と低率であった．以上より，炎症性腸疾患における十二指腸病変は，疾患別に出現頻度や内視鏡所見が異なり，Crohn病では診断的意義があると考えた．

　We retrospectively analyzed prevalence and endoscopic features of duodenal lesions patients with in Crohn's disease, ulcerative colitis, and intestinal Behçet's disease. Among 62 patients with Crohn's disease, duodenal lesions were found in patients. Lesions included notch-like depressions, aphthous erosions, and obvious ulcers. Aphthous erosions were found more frequently in untreated patients than in those receiving medication. Diffuse inflammatory lesions were found in 1 of the 77 patients with ulcerative colitis, and discrete duodenal ulcers were found in 1 of the 22 patients with intestinal Behçet's disease.