胃と腸40巻11号

2005年10月発行

今月の主題 小腸内視鏡検査法の進歩 主題

ダブルバルーン小腸内視鏡検査の有用性―小腸二重造影法との比較

著者： 松本主之¹ 江崎幹宏¹ 森山智彦¹ 中村昌太郎¹ 矢田親一朗¹ 城由起彦¹ 工藤哲司¹ 平橋美奈子² 八尾隆史² 飯田三雄¹

所属機関： ¹九州大学大学院医学研究院病態機能内科学 ²九州大学大学院医学研究院形態機能病理

ページ範囲：P.1503 - P.1517

要旨　ゾンデ法小腸X線検査とダブルバルーン小腸内視鏡検査（DBE）を施行した38例のX線・内視鏡所見を比較した．非限局性小腸疾患（炎症性・びまん性小腸疾患，消化管ポリポーシス）30例中1例ではDBEが十二指腸までしか挿入できなかった．他の29例ではX線の異常皺襞像（皺襞腫大，皺襞消失）10病変の50％，粘膜所見（潰瘍，多発結節，多発顆粒）13病変の92％，変形7病変の100％がDBEで異常所見として観察された．また，29例中9例（31％）でX線正常部にDBEで微細所見が認められた．限局性小腸病変（小腸腫瘍，小腸・小腸吻合部）8例のうち，DBE挿入不能例，X線非描出例，X線・内視鏡非描出例が各1例存在した．他の5例ではDBEで皺襞集中所見が，X線で狭窄部の性状や小腸索との関係が明瞭であった．以上より，DBEは小腸疾患の診断に有用であるが，特に非限局性小腸病変ではX線検査との併用が必要と考えられた．

参考文献

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