腸型Behçet病・simple ulcerの臨床経過

Clinical Course and Treatment for the Intestinal Behçet and So-called ‘Simple Ulcer’

要旨　腸型Behçet病とsimple ulcerの24例を内科的治療のみの例，外科的切除を行った例，再手術を行った例に分けて検討を行った．内科的治療で終わった例はいずれの病変も変形の程度が軽度であった．術後の経過から臨床症状が出現すると潰瘍の再発がみられ，短期間のうちに手術となった例が多かった．したがって，術後は症状がなくても経過観察を行い，軽度な病変のうちに内科的治療を行うことが重要である．内科的治療として，潰瘍を認めたときには経内視鏡的に100％のethanolを撒布し，ED療法を行う．

　We studied the relationship between the clinical course and the treatment in patients with intestinal Behçet (11 cases) and so-called ‘simple ulcer’ (13 cases). We classified them by the therapy into 3 groups (A: treated with drugs, B: treated with only one surgical operation, C: treated with more than one operation).

　At initial examination, the lesions which were cured or reduced in size by medical therapy showed shallow ulceration, mild inflammatory polypoid finding and deformity of the intestinal wall.

　In cases where there was recurrence of the abdominal symptoms after the first operation, apparent ulcerations with stenosis near to anastomosis were proved by examination. There was only a short interval between the recurrence of the symptoms and the second operation for the recurrent ulcers. Therefore, postoperative surveillance for detecting small and shallow ulcers must be performed within a short period after the first operaton.

　For patients with such small and shallow ulcers, absolute ethanol-spraying for the ulcer under endoscopy and an elementary diet were effective.