胃と腸39巻8号

2004年07月発行

今月の主題 家族性大腸腺腫症―最近の話題 主題症例

大腸全摘後のJ-pouch内に発生したポリポーシスに対しsulindacが有効であった家族性大腸腺腫症の1例

著者： 歌野健一¹ 小泉浩一¹ 浦上尚之¹ 千野晶子¹ 増田智博¹ 石山晃世志¹ 保坂尚志¹ 山本頼正¹ 土田知宏¹ 藤崎順子¹ 高橋寛¹ 星野恵津夫¹ 藤田力也¹ 畦倉薫² 上野雅資² 大矢雅敏² 武藤徹一郎² 新井正美³ 宇都宮譲二³ 加藤洋⁴

所属機関： ¹癌研究会附属病院内科 ²癌研究会附属病院外科 ³癌研究会附属病院家族性腫瘍センター ⁴癌研究会癌研究所病理部

ページ範囲：P.1147 - P.1152

要旨　症例は60歳の男性．家族性大腸腺腫症（FAP）の診断で約5,000個のポリポーシスと3個の進行癌を認め，1989年に全結腸直腸切除術・回腸肛門吻合が施行された．術後，上部・下部消化管のサーベイランスを行っていたところ，2001年から残存回腸の腺腫性ポリープの増加・増大傾向がみられ，内視鏡切除を行った．内視鏡切除後に出血による貧血を繰り返したため，ポリープの縮小を狙ってsulindac投与を行った．投与3か月後には回腸ポリープは著明に縮小し数も減少した．sulindacを暫減して投与継続し，ポリープはほぼ消失した状態を保ち特に副作用を認めていない．

参考文献

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