十二指腸狭窄を示した高齢者のCrohn病の1例  [in Japanese] A CASE OF THE DUODENAL CROHN'S DISEASE PRESENTED WITH DUODENAL STENOSIS IN THE ELDERLY  [in Japanese]

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Abstract

狭窄病変を伴った胃・十二指腸Crohn病は本邦では26例の報告例を認めるにすぎない.今回われわれは,十二指腸狭窄を示した高齢者のCrohn病の1切除例を経験したので報告する.症例は66歳,男性.約8年前より食後嘔吐が出現するが放置, 1週間前より食事摂取困難となり来院.上部消化管内視鏡において十二指腸に発赤した小隆起性病変の集簇を認め,また著明な狭窄を示し,十二指腸内への内視鏡挿入は不可能であった.上部消化管造影では,十二指腸球部より下行部にかけて約3cmにわたり,全周性の狭窄を認めた.胃十二指腸部分切除を施行.肉眼的には,十二指腸は幽門輪よりほぼ全周性に浮腫性に肥厚し,縦走潰瘍および敷石状変化を認めた.病理組織学的所見では著明な全層性の炎症性変化および非乾酪性肉芽腫が散見され,十二指腸Crohn病と診断した.術後1年の現在再発の所見なく,健在である.

There have been only 26 cases of gastroduodenal Crohn's disease with stenotic lesion reported in Japan. We report a case of resected duodenal Crohn's disease presented with duodenal stenosis in an elderly patient. A 66-year-old man had begun to suffer from nausea and vomiting ten years before. An endoscopic examination found a diffusely granular appearance in the bulbs, and the endoscope could not pass through the duodenum because of a stenosis. An upper GI series examination revealed a marked circular constriction about 3cm in length between the pyloric ring and the second portion of the duodenum. Partial resection of the stomach and duodenum was performed. The resected specimen showed a longitudinal ulceration and a cobblestone appearance in the duodenum. Histopathological examination showed the non-caseating granulomas scattered through the bowel. The patient is alive and well without any signs of recurrence one year after surgery.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 61(7), 1786-1791, 2000-07-25

    Japan Surgical Association

References:  22

Cited by:  4

Codes

  • NII Article ID (NAID)
    10008502688
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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