血管炎を伴う空腸多発性炎症の1例

抄録

This paper reportes a case of multiple jejunitis with submucosal vasculitis. The patient was a four year and six month old male. Colicy abdominal pain started 24 days before surgical treatment. Fecal occult blood was positive and leucocytosis was seen. Any skin eruption or urinary occult blood was not noticed. Barium meal examination of the small intestine showed a tumor like shadow defect, with irregularity in caliber and destruction of mucosal architecture in the jejunum. Antibiotics and steroid therapy did not releave abdominal pain. A laparotomy demonstrated segmental and multiple inflammation in the jejunum. There were four circular and segmental eroded or ulcerated lesions with edematouse mucosa in the resected jejunum. Histological examination revealed mucosal necrosis, bleeding, edema and infiltration of inflammatory cells with a few vasculitis. We diagnosed this anaphylactoid purpula. We pointed out several resembling factors of this disease with non specific multiple ulcer of the small intestine. If the submucosal ischemic lesion remaines after vasculitis of anaphylactoid purpula subsides, chronic, shallow and sharply demarcated multiple ulcerative lesions may remaine for long time. We implied that nonspecific multiple ulcers of the small intestine may be the result of anaphylactoid purpura.