カプセル内視鏡が診断に有用な疾患―小腸潰瘍─炎症性腸疾患を中心に

Usefulness of Capsule Endoscopy for Patients with Crohn's Disease

要旨　カプセル内視鏡（CE）は，病変の描出能が高く，低侵襲であることから，Crohn病（CD）の診療に非常に有用である．臨床的活動度であるCDAI（Crohn's disease activity index）で寛解と判断される症例の中には，内視鏡的に活動性を有する症例もみられる．そのため，CDの病勢の評価には，内視鏡的な小腸病変の評価が重要であり，CEが果たす役割が大きいと考えられる．ただし，CEのみではCDの初発時の診断は困難で，また，滞留の危険性もあるため，ほかのモダリティーと相補的に検査を行うことが重要である．

　Capsule endoscopy is a very useful tool in the diagnosis of CD（Crohn's disease）because of its excellent ability to image lesions and its low invasiveness. Certain patients found to be in remission according to the CDAI（Crohn's disease activity index）, an indicator of clinical activity, actually have activity detected endoscopically. Endoscopically evaluating small intestinal lesions is therefore an important component of the evaluation of CD activity. Capsule endoscopy could play a major role in this evaluation. Diagnosing CD at disease onset based on capsule endoscopy alone, however, is not feasible. The procedure, moreover, carries the risk of retention. Capsule endoscopy must therefore be used complementarily with other modalities when evaluating CD.