潰瘍性大腸炎における backwash ileitis の臨床病理学的検討

概要

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We carried out a clinicopathologic study of backwash ileitis in ulcerative colitis, chiefly in our own patients. Backwash ileitis was defined as ulcerative colitin (UC) -like inflammation extending beyond the ileocecal valve and spreading homogeneously and diffusely over the ileum. In our department, backwash ileitis was detected in 13 of 45 patients who underwent detailed examination of the ileocecal region, among 60 UC patients who had undergone resection by the end of 1987. Grossly, the affected ileum showed continuous erythema, erosion and ulceration, and, in remission, looked like tenned leather with loss of circular folds. Histologically, inflammation, which was evaluated as mild, moderate or severe, was mild in 7 patients, moderate in 4 and severe in 2. Microscopy revealed that inflammation was not always continuous but sometimes took the form of a skip lesion. The lesion extended over a distance of 9.8cm on average, 29cm at the longest, from the ileocecal valve. There was a significant correlation between backwash ileitis and pestoperative enteritis (p<0.001). This indicated the importance of adequate resection of the ileum in cases of UC accompanied by backwash ileitis and surveillance of postoperative enteritis.
日本大腸肛門病学会の論文