炎症性小腸疾患における小腸ダブルバルーン内視鏡検査―X 線検査との比較

Diagnosis of Inflammatory Diseases of the Small Intestine : Comparison Between Double Balloon Enteroscopy and Double Contrast Radiography

要旨　ダブルバルーン小腸内視鏡検査（DBE）による炎症性小腸疾患の診断能をX線検査との対比で評価した．対象疾患は，Crohn病26例，腸結核7例，NSAIDs腸炎8例と非特異性多発性小腸潰瘍症3例である．狭窄が多いCrohn病と非特異性多発性小腸潰瘍症では，DBE挿入が困難なため観察が不十分であった．一方，腸結核とNSAIDs腸炎では微細な病変が主体であり，DBEの深部挿入が可能なため内視鏡による病変の観察がX線より優れていた．以上から，狭窄や深い潰瘍が生じるCrohn病などの疾患におけるDBEには限界があり，X線検査を組み合わせた慎重な検査姿勢が望まれる．

　The ability to diagnose inflammatory small bowel disease by double balloon enteroscopy (DBE) or by conventional double contrast radiography of the small intestine were compared. The subjects of the present study were 26 patients with Crohn's disease (CD), 7 with intestinal tuberculosis, 8 with NSAIDs enteropathy and 3 with non-specific multiple ulcers of the small intestine (NMUSI). It was hard to observe intestinal lesions fully by DBE in CD and NMUSI because these diseases had stenoses which made full insertion of DBE difficult. In contrast, it was possible to observe even subtle lesions by DBE in intestinal tuberculosis and in NSAIDs enteropathy because there were few areas of stenosis in these diseases. From these observations, it was concluded that stenotic lesions and adhesions of the small intestine in CD or NMUSI eluded full study by DBE and that conventional radiography was more suitable in these cases.