NSAID起因性小腸病変の内視鏡診断と鑑別疾患

NSAID Induced Enteropathy

要旨　カプセル内視鏡検査，バルーン内視鏡検査の普及とNSAID（nonsteroidal anti-inflammatory drug）が長期使用されるケースが増加していることによりNSAID起因性小腸病変が問題となっている．当科で経験したNSAID起因性小腸病変19例では病変存在部位は回腸が17例と最も多くみられた．鑑別すべき疾患としてCrohn病，感染性腸炎，非特異性多発性小腸潰瘍症などが挙げられる．NSAIDの使用中止が望ましいが実際には困難なことも多く，診断，治療が困難なことも多い．

　Capsule endoscopy and balloon endoscopy have entered the clinical arena, allowing the diagnosis of NSAID（nonsteroidal anti-inflammatory drug）induced enteropathy. The most common location of NSAID induced enteropathy was the ileum（17cases ; 89％）. So NSAID induced enteropathy should be considered in the differential diagnosis of Crohn's disease, infectious ileitis, nonspecific multiple ulcers of the small intestine and so on. Discontinuing the use of NSAID is useful for diagnosis and treatment of NSAID induced enteropathy. However, this is usually impractical.