カプセル内視鏡が診断に有用な疾患―小腸腫瘍

Small Bowel Tumors

要旨　当科でカプセル内視鏡検査（capsule endoscopy ; CE）を行った症例のうち，最終的に小腸腫瘍と診断されたのは100例で，多発が67例，単発が33例であった．それらのCEによる存在診断は100例中90例（90％）で可能であった．見逃された10例では2例が多発例で，十二指腸や回腸末端といったCEが急に進むことがある部位の病変であった．単発例の見逃しは，2cm未満の病変が多かった．粘膜下腫瘍の診断は難しいときがあるが，粘膜下腫瘍と壁外圧排との鑑別ポイントはbridging fold，腫瘍表面の緊満感と亜有茎性の外観である．

　We have encountered of 100cases who had small bowel tumors and underwent CE（capsule endoscopy）. They consisted of 67cases with multiple lesions and 33 cases with single ones. The diagnostic value by CE was 90/100（90％）for the existence of tumors. Ten lesions were missed of the total number. They were likely to be in the duodenum and the terminal ileum where CE advances faster than at other sites, and were small-size lesions. Submucosal tumor is often difficult to detect. It is useful to distinguish submucosal tumors from extrinsic ones by the fact that they have bridging folds, tensed surface and a pattern like Isp polyp.