小腸腫瘍性疾患の内視鏡診断

Endoscopic Diagnosis of Small-bowel Tumor

要旨　小腸腫瘍は胃や大腸の腫瘍と比してまれな疾患ではあるが，悪性腫瘍の存在もあり，その診断は重要である．近年，カプセル内視鏡とダブルバルーン内視鏡の登場により，全小腸観察および，小腸腫瘍の内視鏡観察が可能となった．一方，小腸には粘膜下腫瘍が多く生検のみでは診断がつかない場合もあり，その治療方針や追加検査の必要性などを内視鏡所見で適切に判断する必要がある．そのためには病変の表面性状，色調，硬さなどから内視鏡診断を的確に行うことが重要ある．

　Although small-bowel tumors are rare, their diagnosis is important because there is a possibility of their becoming malignant. Recently, endoscopic examination of the entire small bowel and endoscopic observation of small-bowel tumors has become possible through capsule endoscopy and double balloon endoscopy. However, histologic diagnosis of biopsy specimens taken through double balloon endoscopy has sometimes been difficult because submucosal tumors are frequent among small-bowel tumors. Therefore, accurate endoscopic diagnosis by surface appearance, color, solidity etc. is necessary for determinating an appropriate strategy of treatment or indicating the need for further examinations.