Nagashima Makoto, Sugishita Yui, Moriyama Ayako, Ooshiro Mitsuru, Kadoya Kengo, Sato Ayami, Kitahara Tomoaki, Takagi Ryuichi, Urita Tasuku, Yoshida Yutaka, Tanaka Hiroshi, Oshiro Takashi, Nakamura Kentaro, Suzuki Yasuo, Hiruta Nobuyuki, Okazumi Shinichi, Katoh Ryoji
Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan.
Case Rep Gastroenterol. 2013 Aug 24;7(2):352-7. doi: 10.1159/000354974. eCollection 2013.
We report a unique case of giant obstructing inflammatory polyposis associated with ulcerative colitis (UC). A 25-year-old Japanese man with an UC history of 2 years and 6 months was referred to our institution because of diarrhea and melena. His computed tomography scan showed marked dilation of the transverse and descending colon; therefore, we performed total colectomy. Macroscopic evaluation of the excised specimen indicated constricting lesions with giant polyposis in the transverse and descending colon. The polyposis consisted of narrow worm- or noodle-like polyps that bridged over the irregular ulcers. Histologic evaluation of the excised specimen indicated transmural inflammation with a thickened proper muscular layer overlaid with inflammatory polyposis. Based on these data, a diagnosis of giant inflammatory polyposis should be considered in patients who have had UC. Although giant inflammatory polyposis is considered benign, surgical treatment may be indicated to avoid serious complications.
我们报告了一例与溃疡性结肠炎（UC）相关的巨大阻塞性炎性息肉病的独特病例。一名有2年6个月UC病史的25岁日本男性因腹泻和黑便转诊至我院。他的计算机断层扫描显示横结肠和降结肠明显扩张；因此，我们进行了全结肠切除术。对切除标本的宏观评估表明，横结肠和降结肠存在伴有巨大息肉病的狭窄性病变。息肉病由横跨不规则溃疡的狭窄蠕虫状或面条状息肉组成。对切除标本的组织学评估表明存在透壁性炎症，固有肌层增厚，其上覆盖炎性息肉病。基于这些数据，对于患有UC的患者应考虑诊断为巨大炎性息肉病。尽管巨大炎性息肉病被认为是良性的，但可能需要手术治疗以避免严重并发症。
