Kato Kimitoshi, Ishii Yukimoto, Mazaki Takerou, Uehara Toshiki, Nakamura Hitomoi, Kikuchi Hiroshi, Yamagami Hiroaki, Sato Hideki, Mizuno Shigeaki, Soma Masayoshi, Henmi Akihiro, Masuda Hideki, Moriyama Mitsuhiko, Tanaka Masanori
Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Case Rep Gastroenterol. 2013 Jan;7(1):140-6. doi: 10.1159/000350321. Epub 2013 Mar 20.
The etiology of Cronkhite-Canada syndrome (CCS) remains unknown and many cases are refractory to treatment. Therefore, new therapies are urgently needed. Furthermore, a number of CCS cases with gastrointestinal carcinoma have been reported. Our patient had rapid onset of CCS and early development of colon carcinoma associated with adenomas. High anterior resection of the sigmoid colon and ileostomy were performed, and her symptoms and endoscopic and histological findings improved. Helicobacter pylori eradication was carried out 2 years later, surgical closure of an ileal fistula the following year. After 4 months, upper gastrointestinal endoscopy and colonoscopy showed that the CCS lesions had completely disappeared, and biopsies confirmed a normal stomach, duodenum, ileum and colon histologically. The patient has maintained remission for 2 years. The clinical course of this case, showing complete regression of CCS lesions following abdominal colectomy and H. pylori eradication, suggests the significance of H. pylori infection in the treatment of CCS.
克朗凯特-加拿大综合征（CCS）的病因尚不清楚，许多病例对治疗无效。因此，迫切需要新的治疗方法。此外，已有多例CCS合并胃肠道癌的病例报道。我们的患者CCS起病迅速，并早期发生了与腺瘤相关的结肠癌。行乙状结肠高位前切除术和回肠造口术，其症状以及内镜和组织学检查结果均有改善。2年后进行了幽门螺杆菌根除治疗，次年对回肠瘘进行了手术闭合。4个月后，上消化道内镜检查和结肠镜检查显示CCS病变已完全消失，活检在组织学上证实胃、十二指肠、回肠和结肠正常。该患者已维持缓解状态2年。此病例的临床过程显示，在腹部结肠切除术后和根除幽门螺杆菌后CCS病变完全消退，提示幽门螺杆菌感染在CCS治疗中的重要性。
