一過性虚血性大腸炎の1例

Transient-type Ischemic Colitis in the Descending Colon

　近年，本邦においても虚血性大腸炎の報告が増加しているが，われわれは短期間に著明な改善を示した本症の1例を経験したので報告する．

　症　例

　患　者：掛○わ○，70歳，女．

　主　訴：腹痛，下血．

　既往歴，家族歴：特記すべきことなし．

　現病歴：1979年12月7日突然左側腹痛，嘔気，嘔吐出現し，12月8日下血を来したため，当院を受診．直ちに入院となる．

　A 70 year-old female patient was admitted to our hospital on December 8, 1979, with a chief complaint of sudden abdominal pain and anal bleeding. The barium enema study performed on the admission day disclosed saw-tooth irregularity, longitudinal ulcers and sacculation from the upper part to the lower part of the descending colon. On the first endoscopic examination, longitudinal irregular ulcers and scattered islet redness were seen in the descending colon. With conservative therapy, complaints disappeared within several days. The second barium enema study on the 8th hospital day showed slight deformity of the descending colon. And the second endoscopic examination on the 21st hospital day disclosed longitudinal ulcer scars. Selective inferior mesenteric arteriography performed on the 11th hospital day showed the difference of diameter of the marginal artery, the narrowed vasa recta and their sparse distribution, but no vascular occlusion was seen. The patient was discharged from hospital on the 24th day, and no recurrence is seen up to the present.

　From these radiologic and endoscopic findings and the clinical course, this patient was diagnosed as transient type ischemic colitis.