胃と腸52巻7号

2017年06月発行

今月の主題 胃潰瘍は変わったか─新しい胃潰瘍学の構築を目指して

主題

非H. pylori・非薬剤性胃潰瘍

著者： 菅野武¹² 飯島克則³ 小池智幸¹ 八田和久¹ 荒誠之¹ 淺沼清孝¹ 浅野直喜¹ 今谷晃¹ 下瀬川徹¹

所属機関： ¹東北大学病院消化器内科 ²東北大学病院卒後研修センター ³秋田大学病院消化器内科

ページ範囲：P.900 - P.906

文献概要

要旨●非Helicobacter pylori（H. pylori）・非薬剤性潰瘍（特発性潰瘍）はわが国でも潰瘍全体の12%を占めると考えられ，患者背景や好発部位に注目し診療する必要がある．除外診断にガストリノーマ，Crohn病，感染などを確認する．また外傷や熱傷など身体的ストレスに加え，災害時ストレスも独立して潰瘍をひき起こすことが明らかとなった．災害時特殊環境下の出血性胃潰瘍は多発・胃体部発生も多いが，平常時の特発性潰瘍は胃前庭部〜十二指腸球部に多くみられ，動脈硬化性疾患を複数持つ患者がリスクとなり，難治・易再発を呈することもしばしばある．H. pylori除菌後（または自然除菌後）と，H. pylori未感染胃に発生する特発性潰瘍の違いに関しては報告が少なく，より大規模な検証が求められる．

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