腸結核の小腸X線像の分析

Roentgenographic Analysis of Tuberculosis of the Small Intestine

　近年，抗結核療法の進歩，普及に伴い，病理学的には腸結核が非特異性炎症の像を示すにとどまる症例が数多くみられるようになり^1)～3)，クローン病との異同が問題にされてきた^4)～6)．欧米，とくに米国においては，腸結核に関しては散発的な報告をみるのみで，稀な疾患として片付けられ，十分な臨床的病理学的研究がなされていない．しかし，本邦においては，腸結核は決して稀な疾患ではなく，臨床の場では，最近散見されるクローン病との鑑別に苦慮することが少なくない．

　そこでわれわれは，腸結核の診断をより正確なものにするために，病理学的に腸結核と確診された10例の小腸X線像の分析を試みた．

　We studied X-ray films of ten cases of tuberculosis of the small intestine, in whose intestinal mucosa or in mesenteric lymph nodes caseation necroses were found. We obtained these findings as follows.

　1. Deformity at ileocecal region was found only in six of ten cases.

　2. Deformity was chiefly symmetric, however, some revealed eccentric deformity or no deformity.

　3. Ulcers of tuberculosis of the small intestine had roentgenographic characteristics as follows.

　　1) Ulcers were irregular in shape and had fluffy appearance at their margin.

　　2) Cicatrical zone was recognized, which was consisted of fine crepey mucosal appearance and inflammatory polyps.

　　3) Ulcers of various stages and inflammatory polyps were seen simultaneously in a patient.

　And we insist that definite diagnosis of intestinal tuberculosis should be made in such cases as roentgenographic characteristics are found and moreover they get better after antituberculous remedy.