Kato Ryo, Iwamuro Masaya, Hiraoka Sakiko, Takashima Shiho, Inokuchi Toshihiro, Takahara Masahiro, Kondo Yoshitaka, Tanaka Takehiro, Okada Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Acta Med Okayama. 2018 Apr;72(2):105-113. doi: 10.18926/AMO/55850.
To analyze the clinical characteristics of patients with ulcerative colitis who have upper gastrointestinal lesions, we retrospectively reviewed the data of 216 patients with ulcerative colitis who underwent esophagogastroduodenoscopy at our institute in April 2008-March 2016. We investigated the endoscopic features and compared the clinical characteristics between the patients with and without upper gastrointestinal lesions. Forty-two patients (19.4%) had upper gastrointestinal lesions, including multiple erosions (n=18), bamboo joint-like appearance (n=17), mucosa with white spots (n=4), friable mucosa (n=2), ulcer (n=1), and purulent deposits within the mucosa (n=1) in the stomach and/or duodenum. Compared to the patients without upper gastrointestinal lesions, those with upper gastrointestinal lesions showed significantly more frequent extraintestinal manifestations (19.0% vs. 8.0%, p<0.05) and a significant history of colectomy (33.3% vs. 12.1%, p<0.01). There were no significant differences with regard to the sex ratio, age at esophagogastroduodenoscopy, gastrointestinal symptoms, time since the diagnosis of ulcerative colitis, type of colitis at the initial diagnosis of ulcerative colitis, or gastric atrophy between the groups. In conclusion, gastroduodenal lesions were identified in 19.4% of the patients with ulcerative colitis. Esophagogastroduodenoscopy is particularly recommended for ulcerative colitis patients who show extraintestinal manifestations and for those who have undergone a colectomy.
为分析患有上消化道病变的溃疡性结肠炎患者的临床特征，我们回顾性分析了2008年4月至2016年3月在我院接受食管胃十二指肠镜检查的216例溃疡性结肠炎患者的数据。我们研究了内镜特征，并比较了有和无上消化道病变患者的临床特征。42例患者（19.4%）有上消化道病变，包括胃和/或十二指肠的多处糜烂（n = 18）、竹节样外观（n = 17）、有白色斑点的黏膜（n = 4）、黏膜脆弱（n = 2）、溃疡（n = 1）和黏膜内脓性沉积物（n = 1）。与无上消化道病变的患者相比，有上消化道病变的患者肠外表现更频繁（19.0%对8.0%，p<0.05），且有结肠切除术史的比例显著更高（33.3%对12.1%，p<0.01）。两组在性别比例、食管胃十二指肠镜检查时的年龄、胃肠道症状、溃疡性结肠炎诊断后的时间、溃疡性结肠炎初始诊断时的结肠炎类型或胃萎缩方面无显著差异。总之，19.4%的溃疡性结肠炎患者存在胃十二指肠病变。对于有肠外表现的溃疡性结肠炎患者以及已接受结肠切除术的患者，特别推荐进行食管胃十二指肠镜检查。
