胃腸吻合部のポリープ様隆起性病変（いわゆるGastritis cystica polyposa）の1例

A Case of Gastritis Cystica Polyposa

　胃切除後における胃腸吻合部の病変としては，吻合部癌，吻合部潰瘍，吻合部炎，異物肉芽腫などがあるが，比較的まれなものとして，Nikolai²⁾やLittler⁵⁾が報告したポリープ様隆起性病変がある．われわれは12年前に胃切除をうけ最近吐血と下血を頻回にきたし，胃X線検査や内視鏡検査で吻合部ポリポージスと診断され手術を行ない，胃腸吻合部に多数のポリープ様病変を認めた興味ある症例を経験したので若干の文献的考察を加えて報告する．

　A 52-year-old woman was admitted to Kyushu Kosei-nenkin Hospital in August 1975, because of abdominal pain, melena, and loss of weight.

　She had had a gastrojejunostomy for a peptic ulcer of the duodenum twelve years prior to the admission, X-ray examination of the stomach revealed two pigeon-egg-sized and several pea-sized polypoid lesions chiefly in the gastrojejunostomy site.

　Endoscopic study confirmed the diagnosis. Biopsy specimens obtained from all lesions showed no malignant change. Total gastrectomy was carried out in September 1975. Macroscopically three pedunculated polyps and four sessile polyps were observed along the gastrojejunostomy site. All of these polyps were not ulcerated.

　Histological examination showed that the polyps were composed mainly of hyperplasia of foveolar epithelium, some of which were dilated and were filled with eosinophilic homogenous fluid. The macroscopic and histologic features of the lesions were identical with those of regenerative polyps. The pathogenesis of this unique polyposis after gastrectomy is discussed.