大腸の全周性狭窄を呈した好酸球性胃腸炎の1例

大腸に全周性狭窄をきたした好酸球性胃腸炎の1例を報告した｡症例は54才の女性で,腹痛と下痢を主訴に来院した｡上部消化管検査では異常を認めなかったが,下部消化管造影検査と大腸内視鏡検査で横行結腸の全周性狭窄を認め,生検にて大腸粘膜の好酸球浸潤を認めた｡貝料理の摂取にて腹痛発作が出現したが,原因抗原は同定できなかった｡貝類の摂取を避けることにより,症状は消失し,末梢血液中の好酸球増多は消失した｡本邦ではこれまでに124例 の報告があるが,大腸に全周性の狭窄をきたす症例は稀であり,文献的考察を加え報告する｡

We report a case of eosinophilic gastroenteritis with a stenosis in the transverse colon. A patient, 54 year-old-woman, presented to our clinic with abdominal pain and diarrhea. Esophagogastric endoscopy and biopsy were normal. Contrast barium enema examination and colonic endoscopy showed a stenotic segment in the transverce colon. Biopsy specimens obteind from the stenotic segment revealed moderate eosinophilic infiltration in the colonic mucosa. Oral intake of sea shells exacerbated her symptoms. Avoiding sea shells has resulted in the disappearance of symptoms and peripheral blood eosinophilia. The present case was discussed in comparison with the 124 cases heretofore reported in Japan.