腸結核のX線検査理論

A Theoretical Study of X-ray Examination in Intestinal Tuberculosis

　腸結核性病変の諸型を黒丸は8型に分けた（1932）．1，2，3型は点である．6，7型は点が大きくなって面を作りっつあると考える．4型は帯状（横行の線状の要素があると考える）で，5型は縦走するものである．8型は横走と縦走の両要素をもった面である．点，線，面の考え方，線状とその方向，それに多発，などの組合せの要素を考えて診断に対処することになる．

　臨床の実際では，点だけの病変で症状を訴え検査にまわってくることはない．これらは，合併病変として診断的興味の対象となるだけである．また，診断の限界を調べ，他疾患の診断に転用することに意義がある．

　Essentials in the diagnosis of intestinal tuberculosis are to make sure whether a given lesion (1) represents a point, line or a plane, (2) shows transverse or longitudinal direction, (3) is of single or multiple occurrence or (4) shows deformed intestinal lumen. Mixture of these findings does indicate the actual pathologic state of this disease.

　Formerly we used to come across intestinal tuberculosis mostly in its active stage. Now we encounter increasingly this disease (solitary tuberculosis of the intestine) as one of digestive tract diseases in the stage of scarring or overt scar. In a sense intestinal tuberculosis can now be expressed as lymph node tuberculosis of the mesentery.

　Random X-ray pictures of the intestine would naturally fail to depict the lesions, if any. Correct course in our endevor to visualize any lesion is as important as differential diagnosis.

　I have put together here what I think about which kind of a lesion can be depicted to best advantage by which kind of examination methods.