炎症性腸疾患に合併した消化管カルチノイドの２例

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  • Two Cases of Inflammatory Bowel Diseases Associated with Gastrointestinal Carcinoids.

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We report here two cases of inflammatory bowel diseases associated with gastrointestinal carcinoids. Case 1: A 36-year-old woman developed abdominal pain. She was diagnosed as having small and large bowel Crohn's disease, and an ileocecal resection was performed in October, 1988. Duodenal occlusion was found in June, 1993. Diagnosed with a carcinoid tumor by frozen section analysis during the operation, she underwent distal gastrectomy on August 11, 1994. She died of multiple metastases of the lungs and bones on March 4, 1995. Case 2: A 67-year-old woman presented with constipation. She had been treated with salazopyrin since she was diagnosed with ulcerative colitis (total colitis type) in July, 1990. She developed constipation in Januray, 1994, and was diagnosed as having a rectal carcinoid. Low anterior resection was performed on March 3. Laparotomy revealed that she had peritoneal and hepatic metastases, and she died on April 27, 1994. Including the cases described here, a total of 16 subjects have been reported with coexisting Crohn's disease and carcinoid tumors and 20 subjects with coexisting ulcerative colitis and carcinoid tumors. Most carcinoid tumors occur in bowel segments with inflammatory bowel diseases, and in the cases of ulcerative colitis in particular, patients predominantly endure ulcerative colitis for more than 10 years. It is suggested that inflammatory bowel disease may have playeda part in the pathogenesis of carcinoid tumors.

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