| 特集名 | 回盲部潰瘍性病変 | |
|---|---|---|
| 題名 | ［各論］(6) 腸管ベーチェット病と単純性潰瘍の異同 b．違うとする立場から | |
| 発刊年月 | 2013年 08月 | |
| 著者 | 高木 靖寛 | 福岡大学筑紫病院消化器内科 |
| 著者 | 平井 郁仁 | 福岡大学筑紫病院消化器内科 |
| 著者 | 矢野 豊 | 福岡大学筑紫病院消化器内科 |
| 著者 | 古賀 章浩 | 福岡大学筑紫病院消化器内科 |
| 著者 | 松村 圭一郎 | 福岡大学筑紫病院消化器内科 |
| 著者 | 長浜 孝 | 福岡大学筑紫病院消化器内科 |
| 著者 | 久部 高司 | 福岡大学筑紫病院消化器内科 |
| 著者 | 松井 敏幸 | 福岡大学筑紫病院消化器内科 |
| 著者 | 岩下 明德 | 福岡大学筑紫病院病理部 |
| 著者 | 原岡 誠司 | 福岡大学筑紫病院病理部 |
| 著者 | 池田 圭祐 | 福岡大学筑紫病院病理部 |
| 著者 | 田邊 寛 | 福岡大学筑紫病院病理部 |
| 著者 | 二見 喜太郎 | 福岡大学筑紫病院外科 |
| 著者 | 前川 隆文 | 福岡大学筑紫病院外科 |
| 【 要旨 】 | 当科における単純性潰瘍（SU）もしくは腸管ベーチェット病（BD）と診断された27例を，ベーチェット病確診（definite BD；DBD）群，ベーチェット病疑い（suspected BD；SBD）群，非ベーチェット病（non-BD；NBD）群に分けて見直し，各群の頻度，消化管病変の分布と性状，臨床経過について検討した．その結果，(1) 各群の頻度はNBD 5例（19％），SBD 12例（44％），DBD 10例（37％）でNBDは低頻度であった．(2) 各群ともに高頻度で回盲部の定型的病変を認めたが，NBD群の80％が回盲部に限局するのに対し，SBD，DBD群は回盲部限局が42％，30％と少なく，回盲部以外の食道，回腸，大腸にも多発する症例が認められた．(3) 経過中にNBDからBD症状を発症したものはなかったが，SBD，DBDの各1例群で病型の進展が認められた．(4) NBD群の手術率は3例60％で，これらは全例が再手術を受けていた．SBD，DBD群の手術率は9例41％で，これらの再手術率は56％であった．以上から，各群ともに回盲部に好発するが，NBDは頻度が低くBD症状を発症するものはまれで，回盲部に限局するのに対し，SBD，DBDは回盲部以外にも多発する可能性や病型の進展するものがありNBDとSBD，DBDの間で病態が異なる可能性が示唆された． | |
| Theme | Ulcerative lesions in the ileocecal region | |
|---|---|---|
| Title | Defining intestinal Behçet's disease and simple ulcer : the different entities ? | |
| Author | Yasuhiro Takaki | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Fumihito Hirai | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Yutaka Yano | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Akihiro Koga | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Keiichiro Matsumura | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Takashi Nagahama | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Takashi Hisabe | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Toshiyuki Matsui | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author | Akinori Iwashita | Department of Pathology, Fukuoka University Chikushi Hospital |
| Author | Seiji Haraoka | Department of Pathology, Fukuoka University Chikushi Hospital |
| Author | Keisuke Ikeda | Department of Pathology, Fukuoka University Chikushi Hospital |
| Author | Hiroshi Tanabe | Department of Pathology, Fukuoka University Chikushi Hospital |
| Author | Kitaro Futami | Department of Surgery, Fukuoka University Chikushi Hospital |
| Author | Takafumi Maekawa | Department of Surgery, Fukuoka University Chikushi Hospital |
| [ Summary ] | There were 27 cases which were diagnosed as being simple ulcers or Behçet's disease. They were divided into three groups : definite Behçet's disease (DBD), suspected Behçet's disease (SBD), and non-Behçet's disease (NBD). We organized the frequency, location and type of gastrointestinal involvement, and clinical course into respective groups. The results were as follows : (1) frequencies of the three groups were：5 cases in the NBD group (19 %), 12 cases in the SBD group (44 %), 10 cases in the DBD group (37 %). The frequency of the NBD group was the lowest. (2) rates of typical lesions in the ileocecal region were high in all the three groups. However, 80 % of the lesions in NBD cases were located only in the ileocecal region, whereas the rates of lesions limited to the ileocecal regions in the SBD and DBD groups were 42 % and 30 %, respectively. In cases of the SBD and DBD groups, lesions were frequently found in the esophagus, ileum and colon. (3) manifestations of Behçet's disease were not observed in the NBD group. Disease stage progression was seen in one patient with SBD and one with DBD. (4) surgical operations were performed in three cases (60 %) in the NBD group. All of these three patients underwent subsequent operations. Nine cases (41 %) in the SBD/DBD group underwent surgical procedures. 56 % of those nine cases underwent subsequent operations. In relation to the above information, the following ideas are suggested : the frequency of ileocecal lesions in all three groups was high. However, cases in the NBD group exhibited symptoms of Behçet's disease, which occured rarely and were limited to the ileocecal region. On the other hand, some cases in the SBD/DBD group displayed disease stage progression. The NBD group and the SBD/DBD group may exhibit different disease characteristics. |
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