閉塞性大腸炎症例の臨床的検討

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We have studied twelve patients with obstructive colitis from clinical and pathologic viewpoints. The incidence of obstructive colitis was 2.1% (12/573) of patients with colonic cancer. There was no characteristic symptom referable to obstructive colitis and it was hard to examine oral-side of the colon sufficiently because of the stenosis. So it was difficult to diagnose obsuructive colitis preoperatively. All patiens with obstructive colitis had cancer of the left colon. The shape of ulcerative lesion was longitudinal in three patients and irregular in eight patients. In all cases, normal mucosa remained between cancer and ulcerative lesion. The depth of ulcerative lesion was mostly shallow (confined to the submucosa). By microscopic study the degeneration of necrsis of the mucosa and bleeding into the mucasa or submucosa were found. In addition to non-specfic degenerative mucosal and submucosal layers, ghost-like appearance of the mucosa or hemosiderin taken macrophages were also discernible in some cases, which strongly suggest the ischemic nature of the lesion. The caliber ratio which was measured in resected specimen (oral-side of the tumor/anal-side) was compared in two groups (the group with obstructive colitis and the group without obstructive colitis). There was significant difference in the ratio of the two groups. Consequently it was considered to be important to pay attention to the possible presence of obstructive colitis in the patient of left-side colon cancer with dilatation of oral-side colon.
日本大腸肛門病学会の論文

閉塞性大腸炎症例の臨床的検討

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