胃と腸47巻10号

2012年09月発行

今月の主題 難治性Crohn病の特徴と治療戦略

主題

消化管悪性疾患の特徴―小腸・結腸悪性疾患

著者： 江崎幹宏¹ 池上幸治¹ 河内修司² 浅野光一¹ 檜沢一興³ 中村昌太郎¹ 熊谷好晃⁴ 平橋美奈子⁴ 渕上忠彦² 飯田三雄³ 松本主之¹

所属機関： ¹九州大学大学院病態機能内科学 ²松山赤十字病院胃腸センター ³公立学校共済組合九州中央病院 ⁴九州大学大学院形態機能病理学

ページ範囲：P.1545 - P.1557

文献概要

要旨　小腸・結腸腫瘍を合併したCrohn病7例のX線・内視鏡所見を遡及的に検討した．腸閉塞症状を契機に診断された4例では，いずれも腫瘍はX線下に全周性狭窄の像を呈し，3例で病変肛門側，1例で病変口側に周堤様隆起が認められた．一方，Crohn病の経過観察目的に行われた消化管検査が診断契機となった3例では，腫瘍はX線下に境界明瞭な無茎性ないし扁平隆起の像を呈し，内視鏡下に絨毛状様の表面模様が確認された．腫瘍発見までの画像経過を検討できた6例中4例において，腫瘍は狭窄や瘻孔を伴わない炎症粘膜に発生していた．以上より，Crohn病においても定期的なX線・内視鏡検査は小腸・結腸腫瘍の早期診断に寄与する可能性が示唆された．

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