小腸X線検査法の実際と診断の考え方

Double Contrast Method and Radiological Diagnosis of the Small Bowel

要旨　小腸のX線検査には，経口追いかけ法，二重造影法（ゾンデ），逆行性空気注入法などがある．炎症性疾患の診断には二重造影法が欠かせない．この方法では蠕動などの偽陽性像がなく，器質的変化を的確に現せる．炎症性疾患の診断では，まず特徴的な潰瘍の形を捕らえ（点・線・面の要素），次いで病変の分布状態（単発・多発－散在，skip，区域，びまん）を考える．潰瘍の深さ，好発部位，臨床的事項も大いに参考になる．変形の現れ方で潰瘍の形が推定でき，病変の分布と共に，二重造影法でなければ確実な診断は困難である．

　The double contrast method by means of duodenal intubation and administration of barium and air is best suited for diagnosis of the small bowel disease.

　Merits of this method are as follows.

　1) Examination time is shorter than follow through method.

　2) False positive findings by peristalsis can eliminated by injection of antispasmodics.

　3) Not only big but small and fine mucosal abnormalities can be well observed.

　The shapes of ulcerations of inflammatory bowel disease are divided to Point, Line and Area and for presumption of them, deformity of the wall is the most important indication to be looked for.

　The distribution pattern of ulcerative lesions is Single or multiple-Sporadic, Segmental or Diffuse.

　Characteristic findings can be found in each inflammatory disease by analysis of the shape of ulcerations and the distribution pattern.

　Inflammatory small bowel disease should be diagnosed by double contrast method by studying the shape and the distribution pattern of ulcerative lesions.