Minagawa Tomohiro, Ikeuchi Hiroki, Kusunoki Kurando, Kuwahara Ryuichi, Horio Yuki, Kihara Takako, Hirota Seiichi, Uchino Motoi
Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
Surg Case Rep. 2021 Jun 29;7(1):153. doi: 10.1186/s40792-021-01214-7.
Cap polyposis (CP) is extremely rare in Japan, and there is no established cure. We report a case in which CP was improved by surgical treatment.
A 48-year-old man was investigated at a local hospital because of diarrhea and bloody stools in 2018. The patient was treated with metronidazole for suspected amoebic dysentery, but his symptoms did not improve. Subsequent close examination revealed possible CP, but treatment with 5-aminosalicylic acid and a steroid enema had no effect. The patient was then referred to our hospital. The bloody stools, diarrhea, and abdominal pain worsened despite medical treatment, so laparoscopic-assisted total proctocolectomy and ileal J-pouch anal anastomosis with ileostomy were performed. CP has no known cause or established treatment, but Helicobacter pylori (HP) infection has been reported in many CP cases in Japan, and HP eradication is often successful. This patient was HP-negative and did not improve with antimicrobial treatment, but the symptoms improved after surgery.
Even after surgery, CP recurrence reportedly occurs within a short period in many cases. However, our patient has had no signs of CP recurrence during 1 year of follow-up.
在日本，息肉病极为罕见，且尚无成熟的治疗方法。我们报告一例经手术治疗后息肉病病情得到改善的病例。
一名48岁男性于2018年因腹泻和便血在当地医院接受检查。患者因疑似阿米巴痢疾接受甲硝唑治疗，但症状未改善。随后的详细检查发现可能患有息肉病，但使用5-氨基水杨酸和类固醇灌肠治疗均无效。该患者随后转诊至我院。尽管接受了药物治疗，但便血、腹泻和腹痛仍加重，因此进行了腹腔镜辅助全直肠结肠切除术及回肠J袋肛管吻合术并保留回肠造口。息肉病病因不明且无既定治疗方法，但在日本许多息肉病病例中均报告有幽门螺杆菌（HP）感染，且根除HP往往成功。该患者HP检测为阴性，抗菌治疗无效，但手术后症状改善。
据报道，即使在手术后，许多病例在短期内息肉病仍会复发。然而，我们的患者在随访1年期间未出现息肉病复发迹象。
