INTESTINE Vol.17 No.4(2-5)


特集名 回盲部潰瘍性病変
題名 [各論](5) 潰瘍性大腸炎による回盲部病変 ─ 虫垂開口部病変とbackwash ileitis
発刊年月 2013年 08月
著者 堀木 紀行 三重大学医学部光学医療診療部
著者 大北 喜基 三重大学大学院消化管・小児外科
著者 荒木 俊光 三重大学大学院消化管・小児外科
著者 内田 恵一 三重大学大学院先端的外科技術開発学
著者 楠 正人 三重大学大学院消化管・小児外科/三重大学大学院先端的外科技術開発学
著者 竹井 謙之 三重大学大学院消化器肝臓内科
【 要旨 】 潰瘍性大腸炎(UC)の虫垂開口部病変はまれな所見ではなく,むしろUCを疑わす重要な所見である.直腸炎型あるいは左側大腸炎型,とくに直腸炎型に高率にみられ,全大腸炎型には比較的少なく,区域型にもみられる.全大腸炎型UCにおいて,右側結腸から回盲弁を越えて口側の回腸末端部にも連続して炎症が広がる場合,backwash ileitisとして認知されている.外科手術を要する重症全大腸炎型UC症例にみられ,手術時に初めて発見されることが多い.可逆性の病変であり,可能な限り回腸を温存することが重要である.
Theme Ulcerative lesions in the ileocecal region
Title Ileocecal lesions associated with UC : skip lesions in appendiceal orifices and backwash ileitis
Author Noriyuki Horiki Department of Endoscopy, Mie University School of Medicine
Author Yoshiki Okita Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
Author Toshimitsu Araki Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
Author Keiichi Uchida Department of Innovative Surgery, Mie University Graduate School of Medicine
Author Masato Kusunoki Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine / Department of Innovative Surgery, Mie University Graduate School of Medicine
Author Yoshiyuki Takei Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
[ Summary ] Skip lesions associated with appendiceal inflammation in patients with ulcerative colitis (UC) are known as ulcerative appendicitis in Europe and the U.S.A. Endoscopic finding exhibit redness and minute erosions of the appendiceal orifice. The incidence of skip lesions in the appendiceal orifice are reported to be 12-75 % and a common characteristic feature. However, no relationships have been reported between appendiceal involvement and the extent of colitis, nor between appendiceal involvement and the severity of disease. Extension of the inflammatory process to the terminal portion of the ileum in patients with UC is commonly known as backwash ileitis (BI). BI may reversible and does not affect postoperative outcomes for ileal pouch-anal anastomosis. Surgeons should not sacrifice involved areas of the ileum for patients with UC or BI.
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