直腸・肛門管における非腫瘍性疾患の内視鏡診断

Endoscopic Diagnosis of Non-neoplastic Disease in the Rectal and Anal Canal

要旨●直腸・肛門管における非腫瘍性疾患としては，直腸粘膜脱症候群や肛門ポリープをはじめ，Crohn病や潰瘍性大腸炎，cap polyposis，lymphoid follicular proctitis，放射線性直腸炎，急性出血性直腸潰瘍，宿便性潰瘍などの炎症性腸疾患，さらに薬剤関連性腸炎や性感染症を含む感染性腸炎など，多彩な疾患が存在する．診断ツールとしては内視鏡検査が大きく貢献しており，直腸・肛門部の病変を詳細に観察できるだけでなく，組織学的検査を併用可能である点も大きな利点である．本稿では直腸・肛門部の非腫瘍性疾患における内視鏡診断について，自験例を交えながら概説する．

　Non-neoplastic diseases of the rectum and anal canal include a variety of conditions, including rectal mucosal prolapse syndrome ; anal polyps ; and inflammatory bowel diseases, such as Crohn's disease, ulcerative colitis, cap polyposis, lymphoid follicular proctitis, radiation proctitis, acute hemorrhagic rectal ulcers, and fecal ulcers. A broad spectrum of infectious diseases, including drug-induced enterocolitis and sexually transmitted infections, may also affect this region. Endoscopy offers detailed visualization of the rectal and anal lesions, playing a critical role in the diagnosis of non-neoplastic diseases in this location. The ability to facilitate concurrent histologic examination during endoscopy is a major advantage that enhances diagnostic accuracy. This article reviews the endoscopic diagnosis of non-neoplastic diseases of the anorectal region by providing illustrative cases drawn from our clinical experience.