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[{"subitem_description": "潰瘍性大腸炎大腸全摘の術後晩期合併症として, 回腸嚢炎は頻度が高い. 今回大腸全摘後に, 小腸に回腸嚢炎に類似した病変をきたした症例を経験したので報告する. 症例は23歳女性. ステロイド依存性の全大腸炎型潰瘍性大腸炎に対し大腸全摘, W型回腸嚢肛門吻合, 一時的回腸人工肛門造設術を施行した. 合併症なく退院したが20日後に嘔気, 腹痛にて再入院した. 画像検査でイレウス像を認めイレウス管を挿入した. その後高熱を伴う多量の水様便が出現した. 経過から回腸嚢炎類似の病態を考え, ciprofloxacinを投与したところ解熱した. 水様便は継続しhydrocortisone sodium succinateを開始後に改善した. 大腸内視鏡では回腸嚢炎は認めず, 回腸人工肛門の肛門側まで特記すべき所見はなかった. 小腸内視鏡では, 人工肛門口側から70cmまでの回腸にびらんが散在し, 人工肛門に近い位置ほど潰瘍が多発していた. すでに治癒過程の所見となっており, 入院52病日に退院した. 2ヵ月後に人工肛門閉鎖術を行い, 合併症なく経過した. 回腸嚢炎の原因は未だ明らかではないが, 腸内細菌叢との関連や, 大腸全摘後も免疫異常が継続することが一因ではないかと報告されている. 本症例では回腸嚢炎はなかったが, 消化管の排出口となる位置に回腸嚢炎に類似した非特異的な炎症を認め, 回腸嚢炎と同様の治療が奏功した. 腸閉塞による人工肛門口側での便の貯留が, 回腸嚢内での便貯留と同様に, 回腸嚢炎類似病変発症の一因となった可能性がある. 回腸嚢炎の成因を探る上で便の内容, 貯留との関連を示唆する有用な症例と考え, 報告する.", "subitem_description_type": "Abstract"}]}, "item_7_full_name_3": {"attribute_name": "著者別名", "attribute_value_mlt": [{"nameIdentifiers": [{"nameIdentifier": "58553", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Hosoi, Mana"}]}, 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