炎症性腸疾患手術例における腸管外合併症の検討 : 手術が腸管外合併症に与える影響について The Influence of Abdominal Surgery on Extraintestinal Manifestations of Inflammatory Bowel Disease

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著者

    • 高橋 賢一 TAKAHASHI K.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 舟山 裕士 FUNAYAMA Y.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 福島 浩平 FUKUSHIMA K.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 柴田 近 SHIBATA C.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 小川 仁 OGAWA H.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 西條 文人 SAIJO F.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 長尾 宗紀 NAGAO M.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 羽根田 祥 HANEDA S.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 渡辺 和宏 WATANABE K.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 工藤 克昌 KUDO K.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 神山 篤史 KOUYAMA A.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine
    • 佐々木 巖 SASAKI I.
    • 東北大学大学院生体調節外科学分野 Department of Surgery, Division of Biological Regulation and Oncology (Gastrointestinal and Colorectal Surgery), Tohoku University Graduate School of Medicine

抄録

潰瘍性大腸炎(UC)とCrohn病(CD)の手術例における腸管外合併症の種類と頻度手術前後の経過について当科経験例を対象に検討を行った.UC233例中103例(44.2%),CD233例中99例(42.5%)に腸管外合併症が認められた.UC,CDともに胆石症が最多で,各々28例(12.0%),29例(12.4%)であった.その7割は術後に発症し,CDでは小腸型で有意に多かった.CDに特徴的な合併症としては微量元素・ビタミン欠乏症が20例(8.6%)に認められた.UCでは末梢関節炎,壊疽性膿皮症,ブドウ膜炎が各々20例(8.6%),16例(6.9%),7例(3%)に認められた.壊疽性膿皮症とブドウ膜炎は大腸全摘術後に改善することが多かったが,関節炎は逆に悪化または新たに発症することが多かった.UC,CDの外科治療では手術が各腸管外合併症に与える影響をよく理解することが重要である.

We investigated the incidence and clinical course of extraintestinal manifestations (EIM) in 233 patients with ulcerative colitis (UC) and 233 patients with Crohn's disease (CD) who underwent abdominal surgery in our department. One hundred and three patients with UC (44.2%) and 99 patients with CD (42.5%) exhibited one or more ElMs. Cholelithiasis was the most frequently observed EIM and occurred in 28 patients with UC (12.0%) and in 29 patients with CD (12.4%). About 70% of cholelithiasis occurred after abdominal surgery in patients with UC as well as with CD. In patients with CD, cholelithiasis was more frequent in patients with ileitis than in patients with ileocolitis (p<0.05) or patients with colitis (not significant). As for specific ElMs to CD, vitamin or trace element deficiency was found in 20 patients with CD (8.6%). In patients with UC, peripheral arthritis, pyoderma gangrenosum and uveitis were frequently observed EIMs, which developed in 20 (8.6%), 16 (6.9%) and seven patients (3%), respectively. Most of the cases of pyoderma gangrenosum and uveitis improved after total colectomy. However, most of the cases of peripheral arthritis deteriorated or developed after total colectomy. For surgical therapy of UC or CD, it is important to know well the influence of bowel resection on the clinical course of EIMs.

収録刊行物

  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 59(7), 378-384, 2006-07-01

    The Japan Society of Coloproctology

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被引用文献:  1件中 1-1件 を表示

各種コード

  • NII論文ID(NAID)
    10018260562
  • NII書誌ID(NCID)
    AN00195100
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00471801
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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