緊急内視鏡検査

Emergency Endoscopy in the Upper Gastrointestinal Tract

　消化器病学の分野における緊急事態のなかで，上部消化管内視鏡検査で診断可能なもの，また異物嚥下や突然の大出血に際しては治療も可能な事態について述べてみたい．消化管内視鏡検査の現況では，出血に対する内視鏡医の役割は診断と経過観察しかないが，異物嚥下の場合には治療の役も果せるのである．私どもは以下診断，治療の2つの方法について過去3年間の経験を記してみたいと思う．

　Urgent endoscopy of the upper gastrointestinal tract has to be carried out in emergency situations, i.e. hemorrhage or in the case of swallowed foreign bodies. In a 24-hour emergency endoscopy service we have examined a total of 241 patients presenting with bleeding (time period: 1. 1. 1970～31. 3. 1973) . In 86.3％ of the patients the established or probable bleeding source was localized. The majority of bleeding source was found in the stomach, the duodenal ulcer being the most frequent bleeding lesion (16.6％). Bleeding peptic lesions presented more frequently in multiplicity (55.5％). Endoscopic treatment of bleeding by electrocoagulation is still in a preclinical stage. 4 attempts in 2 patients are described. Foreign body treatment by fibreendoscopy has been performed in 22 patients. Impaction in the oesophagus has been treated by mobilization or extraction. Foreign bodies in the stomach or common bile duct were extracted with a special instrumentarium. － It is concluded that emergency endoscopy is highly informative and therapeutically important.