2)下部消化管内視鏡検査

Endoscopic Diagnosis of Lower Gastrointestinal Tract Bleeding

要旨　顕出血を契機に下部消化管内視鏡検査の施行された610症例の疾患名の内訳は，炎症性腸疾患を除いて頻度の高い順に①痔・肛門疾患，②虚血性大腸炎，③進行癌，④非特異性腸炎，⑤腺腫・早期癌・その他のポリープ（若年性ポリープ），⑥憩室症，⑦感染性腸炎，⑧薬剤性腸炎，⑨血管性病変（angiodysplasia，portal hypertensive colopathy），⑩直腸粘膜脱症候群，⑪その他の腫瘍（肉腫，カルチノイド，MALTリンパ腫，血管腫，腸管子宮内膜症），⑫放射線腸炎，⑬腸管嚢胞様気腫症だった．以上の疾患に施行された内視鏡検査の種類および疾患別の症状，内視鏡所見の検討から顕出血を訴えた症例の内視鏡診断の現状を解説した．

　Endoscopy of the lower gastrointestinal tract was performed on 610 cases for visible bleeding and disorders. Diagnoses were as follows in order of frequency. 1) Hemorrhoidal bleeding, 2) Ischemic colitis, 3) Advanced cancer, 4) Non-specific colitis, 5) Adenoma, Early cancer, Juvenile polyp, 6) Diverticular bleeding, 7) Infectious colitis, 8) Drug induced colitis, 9) Angiodysplasia, Portal hypertensive colopathy, 10) Mucosal prolapse syndrome, 11) Sarcoma, Carcinoid, MALToma, Hemangioma, Endometriosis, 12) Radiation colitis, 13) pneumatosis cystoides intestinalis.

　Details of endoscopic examination, clinical manifestations of respective disorders, and the present status of endoscopic diagnosis in patients presenting apparent lower gastrointestinal tract disorders were reported.