INTESTINE Vol.19 No.2(2-2-1)


特集名 小腸の炎症
題名 各論 (2) 感染性炎症性疾患 a. 感染性腸炎(一般細菌感染)
発刊年月 2015年 03月
著者 清水 誠治 大阪鉄道病院消化器内科
著者 三上 栄 神戸市医療センター西市民病院消化器内科
著者 上島 浩一 大阪鉄道病院消化器内科
著者 福田 亘 大阪鉄道病院消化器内科
著者 横溝 千尋 大阪鉄道病院消化器内科
著者 森 敬弘 大阪鉄道病院消化器内科
著者 富岡 秀夫 大阪鉄道病院消化器内科
【 要旨 】 小腸に病変を形成する細菌性腸炎(カンピロバクター腸炎,エルシニア腸炎,サルモネラ腸炎,腸炎ビブリオ感染症,腸チフス,パラチフス)の内視鏡像を中心に解説した.おもな内視鏡所見は回盲弁の腫大,回腸終末部のリンパ組織の腫大・びらん・潰瘍であり,さまざまな程度に観察される.なかでも特徴的なのは,カンピロバクター腸炎における回盲弁潰瘍,エルシニア腸炎における回腸末端炎である.いずれも非感染性の炎症性腸疾患との鑑別が問題となるため十分に認識しておく必要がある.加えて炎症性腸疾患術後にみられるClostridium difficile小腸炎についても触れた.
Theme Intestinal inflammation in small bowel
Title Small intestine bacterial infections
Author Seiji Shimizu Division of Gastroenterolgy and Hepatology, Osaka General Hospital of West Japan Railway Company
Author Sakae Mikami Department of Gastroenterology, Kobe City Hospital Organization Kobe City Medical Center West Hospital
Author Kouichi Ueshima Division of Gastroenterolgy and Hepatology, Osaka General Hospital of West Japan Railway Company
Author Wataru Fukuda Division of Gastroenterolgy and Hepatology, Osaka General Hospital of West Japan Railway Company
Author Chihiro Yokomizo Division of Gastroenterolgy and Hepatology, Osaka General Hospital of West Japan Railway Company
Author Takahiro Mori Division of Gastroenterolgy and Hepatology, Osaka General Hospital of West Japan Railway Company
Author Hideo Tomioka Division of Gastroenterolgy and Hepatology, Osaka General Hospital of West Japan Railway Company
[ Summary ] The types of bacteria which cause acute enteric infections include Campylobacter spp., Yersinia spp., Salmonella spp., Vibrio spp. and Clostridium difficile. Endoscopic findings of enteritis caused by these pathogens are commonly obtained by observation of the ileocecal region with colonoscopy. The basic findings are swelling of the ileocecal valve, as well as swelling, erosions and ulcers of lymphoid tissue in the terminal ileum. These findings are observed to various degrees according to the causative agents. Characteristic findings include ulceration of the ileocecal valve with Campylobacter enterocolitis and of the terminal ileitis with Yersinia infection. Recognition of these conditions is important because discrimination between these infectious diseases and non-infectious inflammatory bowel conditions may be problematic. Clostridium difficile enteritis, which rarely occurs after surgery for inflammatory bowel disease, should be kept in mind.
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