6)ダブルバルーン内視鏡

Diagnostic Imaging Procedures for Gastrointestinal Hemorrhage and Its Development―Double-balloon Endoscopy

要旨　ダブルバルーン内視鏡は深部小腸への内視鏡挿入を可能とした新しい挿入概念に基づく内視鏡である．ダブルバルーン内視鏡の特徴は腸管を短縮しながら深部へと挿入していく挿入性のみならず，深部小腸においても発揮される優れた安定性にある．ダブルバルーン内視鏡の出現によりこれまでは困難であった小腸全域における内視鏡検査・治療が可能となった．小腸出血は消化管出血の中でも最も診断，治療が困難なものであったが，カプセル内視鏡，ダブルバルーン内視鏡の実用化によりこれまでとは比較にならない精度での診断，治療が可能となった．ダブルバルーン内視鏡を用いた消化管出血の診断および治療に関して解説した．

　Double-balloon endoscopy uses a new insertion method which enables deep insertion of an endoscope into the small intestine. Characteristics of the double-balloon endoscopy are not only deep endoscopic insertion while maintaining shortening of the small intestine, but also stability of endoscopic control even after deep insertion. Endoscopic scrutiny and therapy of the entire small intestine became possible with the development of double-balloon endoscopy. Small intestinal bleeding has been the most difficult type of gastrointestinal bleeding to diagnose and treat. However, it has improved remarkably and accurate diagnosis and treatment have become possible with the advent of capsule endoscopy and double-balloon endoscopy. Endoscopic diagnosis and treatment of small intestinal bleeding using double-balloon endoscopy is described in this article.