特発性虚血性腸炎の臨床像

Clinical Features of Idiopathic Ischemic Enterocolitis

要旨●特発性虚血性大腸炎，特発性虚血性小腸炎について概説し，自験例を提示した．特発性虚血性腸炎は，主幹動脈の器質的な閉塞を伴わない腸管粘膜の血流障害に起因する病変のうち原因不明なものであり，狭義の虚血性腸病変とされる．特発性虚血性大腸炎の多くは一過性型で保存的加療により軽快するが，重症例では壊死型や狭窄型へと進展し，手術を要する症例もある．特発性虚血性小腸炎の多くは狭窄型であり，手術を回避できる割合は少ないが，近年内視鏡的なバルーン拡張術の有効性も報告されており，検討されるべき治療選択肢と考えられる．

　We have provided an overview of idiopathic ischemic colitis and ischemic enteritis and discussed our own cases.

　Idiopathic ischemic enterocolitis is a lesion of unknown origin caused by impaired blood flow in the intestinal mucosa without organic occlusion of the main artery, considered as an ischemic intestinal lesion in the narrow sense. Most cases of idiopathic ischemic colitis are transient and can be treated conservatively ; however, in severe cases, the disease progresses to gangrenous or stenotic forms, and some requiring surgery. Most cases of idiopathic ischemic enteritis are stricture type, and although, surgery is rarely avoided, in recent years, the effectiveness of endoscopic balloon dilatation has been reported, and it is regarded as a treatment option.