興味ある胃病変がみられた潰瘍性大腸炎の1手術例

概要

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A 16-years-old male was admitted to our hospital complaining of epigastric pain and high grade fever. He had total colectomy with ileostomy done three months prior to admission for uncontrolled ulcerative colitis by conservative treatment. Upper GI X-ray examination showed poorly pliable stomach with wall stiffness. Endoscopy of upper gastrointestinal tract detected the whole gastric mucosa covered with thick white-coat and mucus. The biopsy specimens taken from the white-coated mucosa were reported as showing marked inflammatory cell infiltration and crypt abscess similar to the histological features of ulcerative colitis. Both symptoms and gastric lesions did not respond to H2-receptor antagonist, but were dramatically alleviated by steroid. There have been reported 4 cases of gastric lesions complicating with ulcerative colitis including our own case. Macroscopic findings are different from each other, but crypt abcess is seen in all cases. It is the fact that histological features of gastric lesions are similar to those of ulcerative colitis in all cases and dramatic response to steroid was seen in 2 cases. The pathogenesis, however, of gastric lesions is a big problem awaiting to be solved.
Japan Gastroenterological Endoscopy Society Kanto Chapterの論文