A Case of Multiple Colonic Diverticulitis Complicated by Coloduodenal Fistula and Extensive Stricture

大腸憩室症の合併症には，憩室炎，出血，穿孔，狭窄などがあり，保存的治療が奏効しなければ時期を逸さず手術を考慮せねばならない．今回我々は，結腸十二指腸瘻をはじめ，広範囲の狭窄など多彩な合併症を併発した大腸憩室炎の1例を経験したので，文献的考察を加えて報告する．症例：37歳，男性．5年前より反復性大腸憩室炎の診断で加療していたが完治せず，下部消化管造影検査などで回腸結腸瘻，結腸十二指腸瘻，結腸膵尾部瘻，腸間膜内膿瘍と広範囲にわたる狭窄を認めた．保存的治療が奏効せず，結腸亜全摘+回腸S状結腸端々吻合および胃瘻造設術を施行した．病理組織学的にも異型性細胞は認めず，憩室は炎症細胞浸潤および肉芽組織をともなっており，急性および慢性的な炎症を繰り返す多発性大腸憩室炎と診断した．

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