大腸内視鏡検査を契機に診断されたビルハルツ住血吸虫症の1例 BILHARZIASIS DIAGNOSED ON COLONOSCOPY

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 症例は,39歳男性.本症に特徴的な血尿や膀胱炎症状等はなく,S状結腸ポリープの治療目的で施行した大腸内視鏡検査にて,上行結腸から直腸に多発した小隆起を認めた.小隆起からの生検組織検査で,粘膜下層に肉芽腫性炎症像を認め,肉芽腫の中心壊死巣内に長楕円形の虫卵を認めた.虫卵の一端には,本症に特徴的なトゲ状の突起が認められビルハルツ住血吸虫症と診断した. ビルハルツ住血吸虫症の内視鏡像に加えて超音波内視鏡像および注腸X線像が得られた症例である.

A 39-year-old male, who did not have hematuria or cystitis-like symptoms on colonoscopy was treated for pedunculated polyps of the sigmoid colon, multiple small whitish protuberances were seen between the ascending colon and rectum. On pathology the lesions were found to consist of a granulomatous inflammatory areas located in the lower layer of the mucosa with elongated ovoid parasitic ova present in the central necrotic foci of the granulomas. At one end of the ova, a characteristic acanthaceous projection was noted, which led to the diagnosis of bilharziasis. The patient had recently traveled to the Republic of Malawi (Africa), an area where bilharziasis is endemic. It was assumed that he was infected with the organism via contact with fresh water during his stay in that country. This patient's inactive bilharziasis was accidentally discovered on a colonoscopy. In addition to endoscopic imaging, ultrasonic endoscopic imaging and double contrast enema. Since the patient had no symptoms and no parasitic eggs were found in feces. The patient required no treatment.

収録刊行物

  • 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy  

    日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 50(7), 1609-1614, 2008-07-20 

    一般社団法人 日本消化器内視鏡学会

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各種コード

  • NII論文ID(NAID)
    10021938130
  • NII書誌ID(NCID)
    AN00192102
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03871207
  • データ提供元
    CJP書誌  J-STAGE 
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