3) 強皮症

Systemic Sclerosis Manifesting a Disorder of the Small Intestine

要旨　強皮症は全消化管に罹患しうるが，食道，小腸，大腸，胃の順に多く，小腸病変は強皮症患者の約50％に認める．上部消化管X線検査では食道中部～下部の蠕動低下と下部の拡張を認める．小腸病変には偽性腸閉塞や腸管嚢腫様気腫症などがある．小腸X線検査所見はhide bound appearance，coil spring appearanceが言われている．今回，CREST症候群に小腸病変を伴った症例を経験し，比較的まれな症例であったので報告する．

　Although systemic sclerosis can cause contraction of the whole digestive canal, it is also frequently recognized in 50％ of gullet, small intestine, large intestine and stomach cases. Esophagography shows gullet dysmotility of the central part and the lower part and dilation of the lower part. The small intestine change includes pseudo-obstruction and pneumatosis cystoides intestinalis.

　Small barium meal study shows hidebound appearance and coil spring appearance. We report this case, in which CREST syndrome accompained the changes in the small intestine, because it is comparatively rare.