15年間アフタ様病変を呈し，突如食道・胃病変を発症し，大腸に縦走潰瘍を生じたCrohn病の1例

Crohn's Disease Becoming Overt after Progression from Aphthoid Colitis after 15 Years Observation, Report of a Case

要旨　患者は初診時26歳，女性．右側結腸粘膜に発赤，浮腫，アフタ様病変を認め，初診から3年間無治療，その後salazosulfapyridine（SASP）で加療され12年間腸管病変はアフタ様病変を認めるのみであった．しかしその後ストレスを契機に突然口腔，食道に多発性難治性アフタが出現し，同時に右側結腸に縦走潰瘍が認められた．絶食，中心静脈栄養管理でほぼ2週間で炎症反応は陰性化，症状も消退し，成分栄養療法を併用して外来管理となり，現在も経過観察中である．

　A 26-year-old woman with only aphthoid lesions in the right-sided colon had been treated by SASP, and she had not shown progression to overt Crohn's disease for 15 years. After that, suddenly oral and esophageal refractory aphthous lesions appeared and, at the same time, longitudinal ulcers presented in the right-sided colon. Enteral nutrition was able to treat the lesion successfully. Thereafter she showed various types of small erosions in her gastrointestinal tract.

　Observation of the changes in the endoscopical findings of small erosions are reported.