心臓疾患，動脈硬化と消化管

Ischemic Lesions of the Digestive Tract, with Special Reference to Cardiac Disease and Atherosclerosis

　消化管に阻血症状をきたす血管病変として，小腸領域では腸管壁小血管の閉塞，急性腸間膜血管閉塞，腸間膜血行不全，腹腔動脈起始部症候群，慢性腸間膜動脈閉塞などが，大腸領域では可逆性ならびに非可逆性の阻血性病変，新生児の壊死性腸炎，大腸癌に合併する局所性腸炎などが報告されているが¹⁾，ここでは主題にしたがって心臓疾患と動脈硬化に伴う消化管の血行障害について述べる．

　Occlusions of the mesenteric arteries may be acute and complete, gradual and partial, or acute and complete superimposed upon a previously narrowed or stenotic vessels. Resently, the transient and reversible ischemic enterocolitis has been interested by many researchers in this field, since the reversible nature of some episodes of colonic ischemia was emphasized in 1963.

　The treatment of acute mesenteric vascular occlusion is emergency surgical intervention, preferably before necrosis and perforation of the bowel has occurred. Yet, the number of patients who are amenable to arterial reconstruction is small, because the early diagnosis is sometimes very difficult. In the cases with abdominal angina, surgical correction is advised not only for the relief of symptoms but also for the prevention of the progression to intestinal infarction. From our clinical and experimental experiences, it may be confirmed that the minute vessel occlusion promotes a series of ischemic changes of the colon, such as hemorrhage, ulceration and necrosis in its mucosa due to degree and extent of occlusion, although its clinical manifestations are various and multiple.