Japanese

Endoscopic Diagnosis for Small Lesions of the Small Intestine Fumihito Hirai 1 , Takahiro Beppu 1 , Taku Nishimura 1 , Noritaka Takatsu 1 , Kazeo Ninomiya 1 , Takehiko Seki 1 , Kenshi Yao 1 , Sumio Tsuda 1 , Toshiyuki Matsui 1 , Kitaro Futami 2 , Akinori Iwashita 3 , Suketo So 4 1Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan 4Tobata Kyoritsu Hospital, Kitakyushu, Japan Keyword: 小腸疾患 , 小病変 , ダブルバルーン小腸内視鏡検査 , アフタ pp.983-993
Published Date 2009/5/25
DOI https://doi.org/10.11477/mf.1403101682
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 To date, small bowel diseases have been mainly diagnosed by X-ray findings. Now, endoscopic modalities for the small intestine, such as video capusle endoscopy(VCE)or balloon endoscopy, have been developed and widely used for diagnosis or treatment of small bowel diseases. Especially, as for the diagnosis of small lesions of the small intestine, endoscopic findings or biopsy are more useful than X-ray findings. Therefore, we analyzed the diagnotic yield of balloon endoscopy.

 〔Patients and Methods〕Two hundred and eighty three patients who underwent double balloon endoscopy(DBE)to observe the small intestine at our hospital were the subjects of this study. We defined lesions equal to or less than 2cm as small lesions of the small intestine in this study. In order to clarify the diagnostic yields of DBE for the small lesions of the small intestine, we investigated frequency, morphological findings and final diagnosis of the small lesions in the subjects.

 〔Results〕Among 283 cases, 189 cases(67%)were shown by endoscopy to have small lesions of the small intestine. Of these 189 cases, 120 cases(63%)had the main or typical lesions of various diseases, and 69 cases(37%)had the small lesions only. As for the former, almost all cases could be diagnosed. On the other hand, as for the later, only half of the cases of the inflammatory diseases were able to be diagnosed by DBE and other diagnostic tools. Diagnosis rate of aphthous lesions equal to or less than 2mm was low, but that of large aphthous lesions, erosions and small ulcers was high, and they were diagnosed as specific diseases such as Crohn's disease, NSAIDs induced enteritis and intestinal tuberculosis.  〔Conclusion〕Patients who underwent DBE were frequently found to have small lesions of the small intestine. However, the diagnosis rate of cases who had only small lesions was not high and the differential diagnosis for small apthous lesion was not satisfactory. Therefore, systematization including DBE and X-ray findings for diagnosis of small lesions of the small intestine is mandatory for the forseeable future.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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