逆行性回腸造影の手技の実際—福岡大学筑紫病院式小腸造影

Retrograde Ileography Using the Sonde Tube of Fukuoka University Chikushi Hospital

要旨●小腸疾患においてX線造影検査は全体像の把握など極めて有用である．しかしながら，経口的にアプローチする小腸造影では，バリウムの停滞，小腸狭窄および癒着などのため下部小腸，特に骨盤内小腸の描出が難しい場合がある．この欠点を補うために逆行性回腸X線造影検査を行うことがあるが，筆者らはバルーンアシスト下小腸内視鏡を用いて独自の方法を開発し，必要に応じて各種の小腸疾患，特にCrohn病に対して行っている．本稿では，福岡大学筑紫病院式ゾンデチューブを用いた逆行性回腸造影の手技について解説する．

　Enterography is extremely useful for detection of small bowel diseases, such as observation of lesions in the entire small intestine. However, it is sometimes challenging to visualize the lower small intestine during enterography using an oral approach, particularly in the pelvic small intestine, due to retention of barium, small bowel stricture, and adhesion. Retrograde ileography is used in such situations to compensate for these disadvantages. A unique method has been developed using balloon-assisted enteroscopy and the sonde tube of Fukuoka University Chikushi Hospital. If needed, this method can be applied in patients with small bowel diseases, particularly Crohn's disease. In this manuscript, we describe the procedure and methods used in ileography.