9.いわゆる非特異性多発性小腸潰瘍症（慢性出血性小腸潰瘍症）

Chronic Hemorrhagic Ulcers of the Small Intestine

要旨　非特異性多発性小腸潰瘍症は，慢性持続性の潜出血と非特異性の浅い多発性小腸潰瘍を特徴とする疾患で，これらの臨床病理学的特徴はCrohn病，腸結核，単純性潰瘍とは全く異なっている．肉眼所見では極めて境界明瞭かつ，横走，斜走ないし融合性の粘膜下層にとどまる潰瘍が認められる．長期的には潰瘍は狭窄を伴いながら難治性・再発性に経過する．X線所見では非対称性の硬化所見や変形，浅いバリウム斑として描出される．本症の報告は決して多くはないが，今後小腸内視鏡の普及により本症の発見頻度が増加する可能性が示唆される．すなわち，本症は慢性・持続性の消化管出血患者では鑑別診断として常に念頭に置くべき疾患と思われる．

　Chronic hemorrhagic ulcers of the small intestine (CHUSI), also referred to as nonspecific multiple ulcers of the small intestine, is a disease characterized by persistent blood loss from multiple, nonspecific ulcers of the small intestine. The small intestinal lesions in CHUSI are comprised of sharply demarcated, shallow, and linear ulcers with circular or diagonal alignment. The ulcers are intractable during a prolonged period of time with a progression to small intestinal stricture. The small intestinal lesions are depicted as eccentric deformities and shallow barium flecks by radiography. Although CHUSI has been considered to be a rare entity, the application of total enteroscopy may contribute to more frequent diagnosis of this disease.