| 特集名 | 虚血性腸炎 -- 最近の知見 | |
|---|---|---|
| 題名 | 若年者，高齢者の虚血性腸炎 | |
| 発刊年月 | 2002年 11月 | |
| 著者 | 藤井 久男 | 奈良県立医科大学中央内視鏡部 |
| 著者 | 松本 寛 | 奈良県立医科大学第一外科 |
| 著者 | 小山 文一 | 奈良県立医科大学第一外科 |
| 著者 | 中島 祥介 | 奈良県立医科大学第一外科 |
| 【 要旨 】 | 若年者と高齢者の虚血性大腸炎(IC)の相違について，IC自験例156例を対象に50歳未満の症例を若年者群(36例)，50歳以上を高齢者群(120例)として比較検討した．若年者に発生するICは高齢者例に比べ，(1) 基礎疾患のないものが多く，便秘など腸管内圧上昇をきたすような腸管側因子を背景に発生する傾向がある，(2) 一過性が多く，(3) 腹痛，下痢，血便といった定型的症状を示すものが多い，(4) 内視鏡所見で縦走びらん潰瘍を認めるものが多い，などの特徴がみられた．高齢者では腹部大動脈瘤手術が狭窄型の，ステロイド治療が壊疽型の危険因子と考えられた．しかし，それ以外には高齢者に発生するICと基本的な病像に相違がないようにみえる． | |
| Theme | Ischemic Colitis -- Current Topics | |
|---|---|---|
| Title | Ischemic Colitis in Young and Elderly Patients | |
| Author | Hisao Fujii | Department of Endoscopy, Nara Medical University |
| Author | Hiroshi Matsumoto | First Department of Surgery, Nara Medical University |
| Author | Fumikazu Koyama | First Department of Surgery, Nara Medical University |
| Author | Yoshiyuki Nakajima | First Department of Surgery, Nara Medical University |
| [ Summary ] | To elucidate the characteristics of age-related clinical features of ischemic colitis, the clinical and endoscopic findings of one hundred fifty six patients with ischemic colitis were analyzed. They were divided into a young adult group, under fifty years old (36 cases) and an elderly group, over fifty (120 cases). In the younger group, the clinical features were characterized by trias of abdominal pain, diarrhea, and bloody stools, along with constipation prior to the onset of symptoms. Endoscopic features were characterized by longitudinal erosions and ulcerations, and patients' clinical courses displayed the transient form of this condition. On the other hand, in the elderly group, many patients had many more complications, some of them exhibiting symptoms of colonic stenosis and gangrenous forms. A history of operations for abdominalaortic aneurysms and a habitual use of steroid hormones may be contributing risk factors for colonic stenosis and the gangrenous form. These findings suggest that ischemic colitis in young patients is not rare, is less severe, and displayed similar symptoms and endoscopic findings to those seen in elderly patients, and that constipation may be related to the pathogenesis of this disease in young patients. |
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