ダブルバルーン小腸内視鏡が診断過程で有用であった小腸結核の1例

Enteric Tuberculosis Diagnosed by Double-balloon Enteroscopy, Report of a Case

要旨　35歳，男性．下血にて近医緊急入院し上下部消化管内視鏡検査を施行されたが，明らかな出血源は認めなかったため，小腸からの出血を疑われ当科紹介入院した．当院で施行されたダブルバルーン小腸内視鏡検査にて，多発する輪状潰瘍を認め，同時に施行された潰瘍辺縁からの生検にて中～高度の炎症細胞浸潤を認め，後に施行された小腸透視の所見と合わせて小腸結核と診断した．抗結核薬を投与したところ症状は軽快し，現在，外来にて経過観察中である．

　A 35-year-old male was referred to our hospital because the source of his gastrointestinal (GI) bleeding was not revealed by conventional examination such as upper GI endoscopy and colonoscopy. The patient then underwent double-balloon enteroscopy in our hospital. We detected multiple circumferential ulcerations of the ileum and the histologic findings of biopsy specimens of these lesions showed a moderate to severe infiltration of inflammatory cells in the lamina propria. Judging by the endoscopic findings and subsequent small bowel series findings, the patient was diagnosed as having enteric tuberculosis. Antitubercular treatment has started and the symptom has improved.