小さな小腸炎症性病変―小腸結核

Intestinal Small Tuberculosis

要旨　ダブルバルーン内視鏡やカプセル内視鏡の開発により，これまで観察不可能であった小腸が観察可能となった．詳細な観察が可能となり腸結核の小さな病変も見つけることができる．また，免疫不全状態で，肺に原発巣のない腸結核がみられるなど疾患頻度は増している．しかしながら，内視鏡やX線といった画像単独の検査だけで確定診断に至るのはいまだ困難である．問診や画像所見などと併せてPCR法やクオンティフェロン（QFT-2G）など新しい検査を加えていくことが診断への早道である．

　The small intestine which was once inaccessible to observation has become observable through the development of the double balloon endoscope and the capsule endoscope. Detailed observation was enabled and it became possible to find small lesions. In addition, intestinal tuberculosis without a primary lesion is often present in lungs of patients in an immunological deficiency state, and the frequency of this disease has increased. However, it is still difficult to make a diagnosis based only on imaging. To make a diagnosis, it is helpful to make a further study using the PCR method or QFT-2G.