山田 博康, 隅岡 正昭, 溝岡 雅文, 渡辺 千之, 小池 則道, 永田 信二, 佐藤 理, 中村 優, 平田 研, 今川 勝

Hiroyasu YAMADA, Masaaki SUMIOKA, Masafumi MIZOOKA, Chiyuki WATANABE, Norimichi KOIKE, Shinji NAGATA, Osamu SATOH, Masaru NAKAMURA, Ken HIRATA, Masaru IMAGAWA

広島県立広島病院第2内科

Second Department of Internal Medicine, Hiroshima Prefectural Hiroshima Hospital

キーワード : Ischemic colitis, Miniature ultrasonic probe system

A miniature ultrasonic probe system (MUS) was used in the colonoscopically guided ultrasonographic examination of 24 patients with transient ischemic colitis, 4 with stricturing ischemic colitis, and 22 healthy subjects. Colonic wall thickness was 1.96±0.75 mm (mean±SD) in healthy subjects, but was 3.3 to 8.0 mm (5.70±1.40 mm) in all cases of ischemic colitis. Colonic-wall thickening resulted mainly from thickening of the submucosa, which averaged 3.75±1.20 mm thick. Hypoechoic portions were scattered throughout the submucosal layer, and the submucosa tended to be more hypoechoic in patients with ischemic colitis than in the healthy subjects. Further, at onset of stricturing ischemic colitis there are many hypoechoic areas scattered in the deep submucosal and proper muscle layers. Thirteen cases that were observed once a week showed decrease in thickening of the colonic wall as their symptoms improved. Although decrease in the thickness of the submucosa was the main finding, small changes in the thickness of the mucosa and the muscularis propria were also observed. While decrease in thickness of the submucosa was observed in stricturing ischemic colitis, the submucosa remained abnormally thick for a week. We conclude that MUS diagnosis of ischemic colitis shows thickening of the colonic wall that occurs mainly in the the submucosa. Thickness decreased, however, as clinical symptoms improved. MUS is thus thought to be useful in the diagnosis of ischemic colitis.