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吐血または下血,あるいはその両者を訴える患者を診たときには,治療の効果をあげるために出血源を早く正確に決定する必要がある.
この目的に使用する診断用の器材としては,レ線と内視鏡がある.レ線は内視鏡より古くから用いられ,その利用もより一般的であるが,顕出血の患者の診断には重大な欠点を有することが漸次明白になった.欠点というのは診断所見がfalse-positiveであったり,false-negativeとなることで,ともに患者や医師を利することは全くない.
For the patient who presents with hematemesis and/or melena, an early and accurate establishment of the bleeding source is mandatory if effective therapy is to be administered.
The diagnostic modalities which are available for this purpose are the radiologic and the endoscopic. While the former is the more time-honored and more generally available, it has become increasingly apparent that its application in the actively bleeding patient is associated with serious deficiencies. These involve both false-positive and false-negative findings, neither of which are in the best interest of the patient or of his physician.
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