特集名 | 下部消化管の出血性病変 | |
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題名 | 直腸粘膜脱症候群 | |
発刊年月 | 1997年 01月 | |
著者 | 山本 雅由 | 横浜市立市民病院外科 |
著者 | 福島 恒男 | 横浜市立市民病院外科 |
【 要旨 】 | 直腸粘膜脱症候群(mucosal prolapse syndrome of the rectum)は,排便時における過度の"いきみ(straining)"により直腸粘膜の脱出が起こり,多くは直腸の前壁に潰瘍性病変や隆起性病変が生じる比較的若年者に多い疾患である.性差はほぼないか,やや男性に多い.臨床症状は出血,粘液分泌,肛門痛等が認められる.診断は大腸内視鏡検査や注腸X線検査,defecography,生検組織検査で行われるが,その組織学的特徴は間質における線維芽細胞および粘膜筋板由来の筋線維の増生(fibromuscular obliteration)である.治療は排便習慣の改善や緩下剤の投与,高線維食の摂取で多くは改善するが,手術的治療が必要な場合もある. |
Theme | Lower Gastrointestinal Bleeding | |
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Title | Mucosal Prolapse Syndrome | |
Author | Masayoshi Yamamoto | Department of Surgery, Yokohama Municipal Citizen's Hospital |
Author | Tsuneo Fukushima | Department of Surgery, Yokohama Municipal Citizen's Hospital |
[ Summary ] | Mucosal prolapse syndrome of the rectum occurs in relatively young patients. Prolapse of the rectal mucosa leads to ulceration and an elevated lesion in the anterior wall of the rectum due to the patient straining excessively during defecation. The male-to-female ratio is aproximately 1:1 or shows a slight male predominance. The salient symptoms are melena, mucus discharge and analgia. Diagnostic procedures include colonoscopy, barium enema, defecography and biopsy of the rectal mucosa. The characteristic pathological diagnosis is fibromuscular obliteration. Improvement of bowel evacuation habits, taking laxatives and a high fiber diet are effective, but in those showing no improvement, surgical treatment is performed. |