選択的プレドニン動注療法が奏効した潰瘍性大腸炎の1例

A Case of Ulcerative Colitis with Marked Implovement Following Selective Administration of Predonisolone into Mesenteric Arteries

　最近われわれは，入院時より激症型を呈し，外科的治療の適応と考えられた全結腸型の潰瘍性大腸炎に対し，2回にわたる選択的プレドニン動注療法により寛解せしめえたと思われる1例を経験したので，若干の考察を加えて報告する．

　CASE.－K.T., A man aged 21 had undergone medical treatment 30 days before on account of ulcerative colitis before he was admitted to our hospital on August 21. 1974, because of general prostration. His condition became better by predonisolone (100 mg/day) enema and blood transfusion. However, he grew worse again 16 days after the admission. The need for emergency surgery was considered due to frequent diarrhea and bleeding. We performed selective angiography on the day before the scheduled operation. After taking angiograms, 25 mg of water soluble predonisolone was administered into both the superior and inferior mesenteric arteries. As a result bleeding stopped within 24 hours, and gradually the symptoms subsided again. After 18th day, the second intraarterial injection of predonisolone was done by the same method. Defecation became normal after the 2nd intraarterial injection of predonisolone. The defecation has been normal ever since.

　This new treatment for the ulcerative colitis was first reported by Baba (1974).

　The evidence of this treatment is that the systemic side effect of steroid was minimized, that the high density of predonisolone acted directly to the bowel wall by one shot injection, and that the range and severity of the lesion was diagnosed safely by angiogram.

　This new treatment should be tried for ulcerative colitis because it can be a trigger for the improvement of the symptoms.