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

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

広島県立広島病院消化器内科

Department of Gastroenterology Hiroshima Prefectural Hiroshima Hospital

キーワード : Drug-associated hemorrhagic colitis, Inflammatory bowel disease, Ischemic colitis, Miniature ultrasonic probe system, Ulcerative colitis

We tried to assess the usefulness of a miniature ultrasonic probe system. Subjects included 24 patents with ischemic colitis of the transient type, 19 with ulcerative colitis, and 5 with drug-associated hemorrhagic colitis; the control group comprised 22 healthy individuals. All patients complained of bloody stool and abdominal pain. Colonoscopy was performed during the symptomatic period, and the miniature ultrasonic probe system was used to observe and estimate the structure of the bowel wall at this time. Bowel-wall hypertrophy was present in all cases of colitis. Respective thicknesses of the mucosal layer, submucosal layer, and muscularis propria layer was 0.97±0.21 mm, 3.85±1.30 mm, and 1.01±0.19 mm in the ischemic colitis group; 1.20±0.28 mm, 1.46±0.34 mm, and 0.89±0.36 mm in the ulcerative colitis group; 0.94±0.33 mm, 3.38±1.3 mm, and 0.68±0.22 mm in the drug-associated hemorrhagic colitis group; and 0.52±0.17 mm, 0.83±0.40 mm, and 0.60±0.26 mm in the control group. Bowel-wall hypertrophy in patients with transient ischemic colitis and drug-associated hemorrhagic colitis resulted mainly from thickening of the submucosal layer, while hypertrophy observed in patients with ulcerative colitis resulted mainly from thickening of the mucosal layer. In view of these findings, examination with the miniature ultrasonic probe system proved useful in diagnosing inflammatory bowel disease.