直腸型Crohn病の1例

Rectal Crohn's Disease, Report of a Case

　Crohn病は消化管のあらゆる部位に発生するとされているが，その多くは回腸，結腸，および両者の混合型である．

　われわれは最近，発生部位的に極めて頻度の低い直腸に病変の主体がみられたCrohn病の1例を経験したので報告する．

　The patient was a 35-year-old man complaining of constipation. By both x-ray and endoseopy a striking stricture was seen in the rectum accompanied with cobbletone appearance. Biopsy of the rectum showed in the lamina propria mucosae a non-caseating granuloma. By these findings a diagnosis of rectal Crohn's disease was arrived at. Only multiple slight elevations were observed roentgenographically as well in the colon ascendens. Rectal Crohn's disease is of rare occurrence in this country. During the past ten years only four cases have been reparted. These cases were diagnosed as such only after the surgical intervention. The present case has been confirmed for the first time before the operation.

　In the U.S. and Europe Farmer et al reported that rectal type was seen in 3.4 per cent of intestinal Crohn's disease, while Williams et al wrote that anorectal type was seen in 11.4 per cent. In the reports hitherto published the anorectal type is seen in more elderly persons with constipation due to the stricture of the rectum, often mistaken for rectal cancer, so that the clinical picture differs from that of ileo-colic type. The patient here described has no perianal disease, and clinically he has few inflammatory findings, so that he is being followed up by controlling the stools with Magnesii Oxydum Ponderosum.