狭窄を来す小腸疾患の診断─内視鏡診断の立場から

Endoscopic Diagnosis of Small Bowel Disease-induced Stricture

要旨●カプセル内視鏡（capsule endoscopy；CE）やバルーンアシスト下小腸内視鏡（balloon assisted endoscopy；BAE）の登場により全小腸の内視鏡的観察が実現し，BAEでは生検で病理組織学的評価も可能となった．小腸疾患の評価には腹部US，X線造影検査，cross-sectional imagingなどの検査法が存在するが，各々有用性と課題が混在し，いずれの検査もgolden standardとはなりえない．狭窄を含めた小腸病変を評価するためには，必要な検査を相補的に行うことが望まれる．本稿では概して評価が不十分となることが多い小腸狭窄を来す代表的な疾患の内視鏡所見を中心に概説する．

　The advent of capsule endoscopy and BAE（balloon-assisted endoscopy）has facilitated the endoscopic observation of the entire small intestine. Furthermore, BAE has facilitated histological evaluation through biopsy. Evaluation methods for small bowel disease include abdominal ultrasonography, X-ray imaging, and cross-sectional imaging; however, each technique has disadvantages and none of these serve as a gold standard. To assess lesions of the small intestine, including strictures, complimentary tests should be performed. In this article, we outline the endoscopic findings of typical diseases that cause stricture of the small intestine for which evaluations are often inadequate.