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要旨 ダブルバルーン小腸内視鏡を施行し,NSAID起因と思われる小腸病変が認められた9症例において,病変の形態としては多発潰瘍が5例,膜様狭窄が3例,輪状潰瘍が1例であり,いずれも多発して認められた.特徴的な膜様狭窄,輪状潰瘍についてはNSAID内服期間が比較的長い症例で認められた.生検により病理所見が得られたものは9例中8例であり,2例において細胞崩壊像,アポトーシス小体などが認められ,いずれも膜様狭窄を来した病変であった.内視鏡通過不能な膜様狭窄の2例はDBE下バルーン拡張術を施行し,拡張後の再発は認められていない.DBEはNSAID起因性小腸炎の診断および治療に有用であった.
Using double balloon endoscopy (DBE), 9 cases were diagnosed with NSAID-induced enteritis. Endosopic findings were multiple ulcers (5 cases), multiple diaphragm-like strictures (3 cases) and multiple circular ulcers (1 case). In cases of long-term NSAID administration, specific diaphragm-like strictures and circular ulcers were pointed out. Of these 9 cases, histological findings were obtained with endoscopic biopsy in 8 cases, and cytolysis image and apoptosis were noticed in 2 cases which had diaphragm-like strictures. Balloon dilation procedures with DBE were performed in 2 cases with diaphragm-like strictures that made endoscopic passage impossible. DBE was useful for the diagnosis and treatment of NSAID-induced enteritis.
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