胃と腸46巻9号

2011年08月発行

今月の主題 若年者の胃・十二指腸病変の特徴 主題

小児のH. pylori感染症の内視鏡所見―小児科医の立場から

著者： 今野武津子¹ 高橋美智子¹ 村岡俊二² 後藤田裕子²

所属機関： ¹札幌厚生病院小児科 ²札幌厚生病院臨床病理科

ページ範囲：P.1353 - P.1362

要旨　小児のH. pylori胃炎の内視鏡所見では104例中98例（94％）に結節性胃炎（鳥肌胃炎）が認められた．結節性胃炎は幽門前庭部一面に特異なびまん性の小結節状の隆起が認められ，体部や十二指腸にまで及ぶこともあった．そして，結節の中心に陥凹を認めた．結節状変化は病理組織所見から，単核球浸潤と大型のリンパ濾胞の増生によるものと考えられた．結節性胃炎98症例のうち，19例は十二指腸潰瘍を合併していた．また，胃潰瘍合併3例のうち2例はH. pyloriの初感染により急性胃粘膜病変を呈した．除菌治療によって結節性変化は6か月以後には消退した．病理組織学的にリンパ濾胞数，炎症細胞浸潤の有意な改善を認めた．

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