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Journal of Medical Ultrasonics

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1997 - Vol.24

Vol.24 No.10

Original Article(原著)

(1633 - 1640)

病原性大腸菌O157による小児の出血性腸炎の超音波像の検討 -ほかの細菌性腸炎との鑑別-

Ultrasonographic Findings in Hemorrhagic Colitis in Child Due to Escherichia coli O157: H7: Differential Diagnosis From Other Bacterial Enterocolitis

片岡 伸一1, 井出 満2, 栄 則久2, 林 光久2, 黒原 進司2, 櫛引 千恵子3, 浅野 恵子3, 西戸 温美3, 橋本 卓4, 武富 浩也4, 大地 宏昭1, 豊永 高史1, 土細工 利夫1, 湯浅 肇5, 廣岡 大司1

Shinichi KATAOKA1, Mituru IDE2, Norihisa SAKAE2, Mituhisa HAYASHI2, Shinji KUROHARA2, Chieko KUSHIBIKI3, Keiko ASANO3, Atumi NISHIDO3, Takashi HASHIMOTO4, Hiroya TAKETOMI4, Hiroaki OOCHI1, Takashi TOYONAGA1, Toshio DOZAIKU1, Hajime YUASA5, Takashi HIROOKA1

1岸和田徳洲会病院内科, 2岸和田徳洲会病院腹部超音波室, 3岸和田徳洲会病院細菌検査室, 4岸和田徳洲会病院小児科, 5天竜厚生会さいわい医療保健部

1Department of Internal Medicine, Kishiwada Tokusyukai Hospital, 2Department of Abdominal Ultrasonography, Kishiwada Tokusyukai Hospital, 3Department of Bacteriology, Kishiwada Tokusyukai Hospital, 4Department of Pediatrics, Kishiwada Tokusyukai Hospital, 5Department of Health Insurance, Tenryu Koseikai Saiwai Hospital

キーワード : Appendix, <I>Campylobacter</I> enterocolitis, <I>Escherichia coil</I> O157: H7, <I>Salmonella</I> enterocolitis, Ultrasonography

We studied five cases of hemorrhagic colitis during an outbreak of Escherichia coli O157: H7 infections in the city of Sakai, Japan, July 1996. All the patients were school children, and all had crampy abdominal pain and bloody diarrhea; however, none had hemorrhagic uremic syndrome. They made favorable progress and were discharged in 1 week. E coli O157: H7 was isolated from the stools of three of them. Sonography showed the mural walls of all the patients to be extremely thick from the cecum to the rectum, and the ileocolic lymph nodes of all five were swollen. Paralytic dilatation of the colon was observed in two patients. The appendix was identified, and moderate amounts of ascites were observed in all five. We studied the sonographic findings of Salmonella enterocolitis and Campylobacter enterocolitis to compare them with those from O157 enterocolitis. The intestinal wall in O157 enterocolitis was thicker throughout the colon than in the other types of bacterial enterocolitis (pCampylobacter enterocolitis(pSalmonella enterocolitis (p=0.04). Ascites was more frequently encountered in O157 enterocolitis(p