Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
症例
潰瘍性大腸炎に憩室炎からの膿瘍によるS状結腸狭窄を合併した1例
杉本 啓芦谷 啓吾都築 義和宮口 和也沼尻 良輝高山 哲嘉深野 敬之金 玲山田 健人大庫 秀樹中元 秀友今枝 博之
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2019 年 95 巻 1 号 p. 114-117

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The complication of diverticulitis in the patients with ulcerative colitis (UC) is rare, because UC is common in young people and diverticulosis in elderly people. Here we presented a rare case of UC with sigmoid colon stenosis due to the abscess derived from diverticulitis.

70-year-old male with 2-year history of ulcerative colitis (UC) treated with 5-aminosalycilic acid (5-ASA) admitted to our hospital due to the recurrence after one-year remission. Blood examination demonstrated elevated white blood cell (WBC) and CRP. Contrast-enhanced computed tomography (CT) demonstrated abscess formation around sigmoid colon with multiple diverticulosis, and thickening of colonic wall from sigmoid colon to rectum. Colonoscopy demonstrated recurrence of UC and sigmoid colon stenosis. Prednisolone improved mucosal inflammation, however, did not improve stenosis and abscess formation. Therefore, sigmiodectomy was performed and resected specimen presented sigmoid colon stenosis with diverticulitis with the infiltration of neutrophils. Differential diagnosis may include superimpose of diverticular colitis in the setting of UC.

Diverticulitis should be considered as differential diagnosis when segmental stenosis was complicated in elderly patients with UC.

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© 2019 一般社団法人 日本消化器内視鏡学会 関東支部
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