潰瘍性大腸炎の臨床経過とX線所見―10年以上の経過

Radiological Follow-up Study of Ulcerative Colitis

要旨　潰瘍性大腸炎で10年以上の臨床経過をみた24例のX線所見の変化を調べた．発症年齢は30歳以上が18例75％を占めた．臨床経過から初回発作型9例，再燃緩解型13例，慢性持続型2例であった．10年以上の経過で再燃したのは3例のみであった．初回所見で罹患範囲・炎症性病変の程度から初回発作型と再燃緩解型の区別は困難であった．X線所見から罹患範囲の拡大は17％にみられた．初回所見から潰瘍の程度が高いほど，全大腸炎型であった．経過中に直腸に活動性所見を認めない区域性所見を33％に認めた．したがって，炎症の経過観察でも全大腸を検査する必要がある．

　During the last 17 years (1973-1990), we experienced 24 cases of ulcerative colitis followed-up clinically over the course of 10 years. To establish natural history of ulcerative colitis, these cases were radiologically studied. The results were as follows:

　1. Of 24 cases, 18 cases (75%) were over 30 years of age at the initial inflammatory episode.

　2. During the follow-up period, inflammatory episode occurred only once in 9 cases, in relapsing-remitting type in 13 cases, in chronic continuous type in 2 cases. Initial radiological findings were not useful in differentiating single episode type from relapsingremitting type of ulcerative colitis.

　3. The inflammatory lesion spread with relapses and flare-ups in 17% of the cases followed-up for 10 years. In the cases with colonic lesion lacking rectal lesion, the spread of the lesion occurred during relapses and flare-up (segmental lesion) in 33%.

　Thus, the follow-up studies of ulcerative colitis should involve the entire colon.