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起因性小腸病変の治療―狭窄例，出血例

著者： 西村直之¹ 山本博徳¹ 砂田圭二郎¹ 新畑博英¹ 佐藤博之¹ 矢野智則¹ 宮田知彦¹

所属機関： ¹自治医科大学内科学講座消化器内科部門

ページ範囲：P.166 - P.172

文献概要

要旨　カプセル内視鏡とダブルバルーン内視鏡（DBE）が開発されて以降，小腸へのアクセスが容易となり，NSAIDsによる小腸傷害への関心が高まっている．それとともに，従来の認識より，高頻度に小腸傷害が発生することがわかってきている．病変は多彩であり，びらんや様々な形態の潰瘍を生じ出血することもある．NSAIDsの内服を中止することで，速やかに治癒することが多いが，それ以外の治療法や予防法は確立されていない．NSAIDs起因性の小腸膜様狭窄を生じた場合，従来は外科的手術が行われていたが，DBEによるバルーン拡張術により有効かつ安全な治療が可能となった．

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