胃と腸46巻2号

2011年02月発行

今月の主題 NSAID起因性小腸病変 主題

NSAID起因性小腸潰瘍のX線診断

著者： 松本主之¹ 蔵原晃一² 平井郁仁³ 江㟢幹宏¹ 梁井俊一¹ 川㟢啓祐² 船田摩央² 二宮風夫³ 別府孝浩³ 矢野豊³ 松井敏幸³ 渕上忠彦³ 飯田三雄¹⁴

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松山赤十字病院胃腸センター ³福岡大学筑紫病院消化器科 ⁴公立学校共済組合九州中央病院

ページ範囲：P.145 - P.155

要旨　小腸X線検査を施行した非ステロイド性抗炎症薬（NSAIDs）起因性小腸潰瘍21例を対象とし，内視鏡所見別にみたX線描出率とX線所見を検討した．高度狭窄病変がみられた4例全例において，X線検査で短い両側性ないし偏側性狭窄が描出された．輪状潰瘍陽性12例中9例（75％）では両側性の管腔狭小化，あるいは線状のバリウム斑がみられ，斜走・縦走潰瘍3例中2例（67％）で偏側性変形ないし線状バリウム斑が描出された．一方，小病変がみられた13例中5例（38％）ではX線で透亮像を伴うバリウム斑が認められた．X線描出15例と非描出6例で臨床像，検査成績，投与NSAIDsに差はなかった．以上より，X線検査を用いることでNSAID起因性小腸潰瘍の粗大病変は診断可能であるが，小病変診断のためには内視鏡検査を優先させるべきと考えた．

参考文献

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