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Stomach and Intestine(Tokyo) Volume 9, Issue 10 （October 1974）

胃と腸 9巻10号（1974年10月発行）

Japanese English

今月の主題症例・研究特集

研究

小腸fiberscopeの開発に関する試み―ゾンデ式小腸fiberscopeの臨床的評価 Clinical Evaluation of Specially Designed Small Intestinal Fiberscope 多田正大 ¹ , 加藤三郎 ¹ , 竹田彬一 ¹ , 須藤洋昌 ¹ , 酉家進 ¹ , 橋本睦弘 ¹ , 郡大裕 ¹ , 川井啓市 ² , 木本邦彦 ² , 中島正継 ² , 宮岡孝幸 ² , 赤坂裕三 ³ M. Tada ¹ , S. Katoh ¹ , Y. Kohli ¹ , K. Kawai ² , Y. Akasaka ³ ¹京都府立医科大学第3内科 ²京都府立医科大学公衆衛生学 ³岐阜歯科大学内科 ¹Kyoto Prefectural University of Medicine, 3rd Dept. of Internal Medicine ²Kyoto Prefectural University of Medicine, School of Preventive Medicine ³Gifu Dental University, Dept. of Internal Medicine pp.1313-1318

発行日 1974年10月25日 Published Date 1974/10/25

DOI https://doi.org/10.11477/mf.1403111828

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　消化管のなかでは，小腸は最も長いにもかかわらず，小腸疾患に対する診断学的アプローチは他の消化管のそれに比べて，著しく遅れていることは事実である¹⁾．小腸の形態学的診断法としては，従来から腹部単純X線検査に始まり，経口的造影剤投与によるX線検査，血管造影法，String-Testあるいは腸紐，盲目的小腸生検などがその中心としてなされてきたが，その成果は必ずしも十分とはいえなかった²⁾．

　近年小腸の内視鏡観察を日的に，経腹腸鏡の先駆的業績³⁾に続いて，小腸fiberscopeの開発がなされ，小腸疾患診断のための努力が報告されている⁴⁾．

　Up to date, several types of specific fiberscope for observing the small intestine have been made, for example, push type, rope way type and “sonde” type “Sonde” type of intestinal fiberscope, Olympus A-250, is 2850 mm in its length and 5.5 mm in diameter of its flexible portion, the tip of which has a leading plumb to guide a fiberscope. The fiberscope is given per os to the patient, and inserted to the small intestine through the esophagus and stomach. But the fiberscope is too small in its width to have a biopsy apparatus.

　To 17 patients we applied this type intestinal fiberscope. In 14 cases (82.4%) of them, the descending part of the doudenum could be observed endoscopically. But the fiberscope reached to the jejunum in 7 cases (41.2%) and to the ileum in only 2 caces (11.8%). Namely, the fiberscope was so flexible and pliable that its loop was easily made in the stomach and it was also difficult to make the fiberscope pass the pyloric ring or the bent of the small intestine. In our trials, the mean time was 1 hour to the descending part of the duodenum, about 2 hours to the “Treitz”and 6 hours to the ileum.

　During the endoscopic examination, the patient felt a pharyngeal pain or an alien feeling of the pharynx, but its degree was too mild.

　Consequently, we cannot satisfy with the obtained insertion ratio of our trials, but in future with the advances of the insertion ratio resulting from the improvements of the fiberscope and its insertion method, we will be able to observe easily and completely the mucosal surface of the small intestine and to perform the endoscopic examination as the screening filter of morphological diseases of the small intestine.