大腸腫瘍診断におけるX線検査の有用性―治療の立場から

The Benefit of Barium Enema in the Diagnosis of Colorectal Tumors from the Point of View of a Surgeon

要旨　最近，大腸内視鏡の進歩と反比例するように，注腸X線検査の価値が軽んじられるようになってきた．本稿では，注腸X線検査が内視鏡検査より優れている実例を挙げながら，注腸X線検査の有用性について述べた．特に注腸X線検査が重要になる場合は，(1)直腸における存在部位診断(Rb，Ra，Rs)，(2)多発癌，(3)吻合予定腸管における憩室の有無，(4)壁変形の著しい癌，(5)閉塞性大腸炎を併発している癌，(6)横行結腸における存在部位診断，である．注腸X線検査は，病変部の客観的部位同定と狭窄部の口側情報の獲得に欠かせない検査であり，現場で治療を行っているわれわれ外科医にとっては，必要不可欠なものである．

　The technology of endoscopic examinations has progressed, but the value of barium enema (BE) has recently been neglected. In the present paper we discussed the benefit of BE mentioning cases which showed the superiority of BE over endoscopic examinations. Cases in which BE is especially important are as follows: (1) The diagnosis of locus in the rectum (Rb, Ra, Rs). (2) Cases of multiple cancers. (3) The distribution of diverticuli. (4) Cancers which show severe deformity of the surrounding colon. (5) Cancers complicated by obstructive colitis. (6) The diagnosis of locus in the transverse colon. BE is essential to assess the locus of a lesion objectively and to obtain information about the oral side of a severe narrowing lesion. It is concluded that BE is indispensable for surgeons engaged in treatment of patients with colorectal cancers.