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36 歳の女性が、3 週間にわたる血性下痢と下腹部痛で入院。病歴を調べたところ、過去7年間に同様の症状が4回あったことが判明した。S状結腸鏡検査により、直腸粘膜の紅斑性、潰瘍化、浮腫性が認められた。ステロイド治療を開始したが症状は改善せず、彼女は結腸全摘手術を受けた。
Product information "Ulcerative Colitis"
Clinical History
A 36-year old female was admitted to hospital with a 3-week history of bloody diarrhoea and lower abdominal pain. Further history taking revealed 4 similar episodes of diarrhoea and abdominal pain of over the past 7 years. Sigmoidoscopy showed a erythematous, ulcerated and oedematous rectal mucosa. She was commenced on steroid treatment but her symptoms failed to improve. She underwent a total colectomy.
Pathology
The resected colon has been sliced open longitudinally to show the mucosal surface. There is extensive confluent ulceration separated by oedematous islands of residual mucosa. The ulcers have necrotic bases with overhanging edges some of which form ‘pseudo’-polyps. Histology of the bowel mucosa showed acute inflammatory changes with crypt abscesses, focal necrosis and ulceration. This is an example of acute ulcerative colitis (UC).
Further Information
Ulcerative colitis is a chronic ulcero-inflammatory disease that usually involves the rectum and can extend proximally in a continuous pattern to involve other parts to the colon. The inflammatory process is diffuse but is generally limited to the mucosa and superficial submucosa. The triggering factor for UC in unknown. It most commonly begins between the ages of 15-25 years and is slightly more common in females.
UC patients can present with diarrhoea, which may contain blood or mucus, faecal urgency, faecal frequency, tenesmus, colicky abdominal pain, as well as weight loss, anaemia and fatigue. Colonic inflammation can lead to toxic megacolon, colonic perforation or colon cancer. Extraintestinal manifestations include anterior uveitis, migrating polyarthritis, sacroileitis, ankylosing spondylitis, erythema nodosum, pyoderma gangrenosum and primary sclerosing cholangitis.
Treatments of UC include use of anti-inflammatory drugs such as steroids, disease modifying rheumatoid drug and TNF (tumor necrosis factor) inhibitors. Colectomy essentially cures intestinal symptoms of UC but extraintestinal manifestations of the disease may persist.
●京都科学品番：EZ-280 ●メーカー品番：MP2074
Erler-Zimmer GmbH & Co.KG の模型製品は、
日本国内において株式会社京都科学の独占販売製品です。
