小腸のX線診断

X-RAY DIAGNOSIS OF THE SMALL INTESTINE

Ⅰ．X線検査法（第1表）

1．腹部透視および単純撮影法

　小腸の疾患で本法の適応となるのは主としてIleusのときだが，穿孔や結石との鑑別のためにも腹部を広範囲に撮影すべく，使用フイルムは大きい方がよい（大角，半切）．立位撮影が原則だが，仰臥位，腹臥位，側臥位も撮っておくと判定がより確実さを増すことになる．しかしガス像のないIleusのために本法の限界があることは周知の通りである．近年螢光倍増管とテレビジョンの進歩で，透視により麻痺性Ileusと機械的Ileusの区別ができるようになった．

　It is the purpose of this paper to elucidate the roll of x-ray examination in the diagnosis of the small intestine. For this purpose, the authors investigated into this subject by referring to extensive literature on x-ray examination methods of the small intestine, its diseases which are within reach of x-ray diagnosis, and some diseases in which other examination methods are necessary besides x-ray, as well as on the relation of other examination methods to those of x-ray.

　There are scout film examination, oral procedure and barium enema in x-ray examination method of the small intestine. In the oral procedure, some methods to facilitate the passage of the given contrast media have been worked out. Some authors state that angiography is better method than the oral procedure in diagnostic ability.

　Though x-ray examination is useful in finding organic changes of the small intestine, it is far less efficient in the diagnosis of functional disturbances of the small bowel. For their correct diagnosis, other examination methods or clinical findings are requisite. More attention is now being paid to these functional diseases by roentgenologists as well, but x-ray examination is still incompetent in this field.

　Biopsy and radioisotopes are commendable because they supplement what is lacking in x-ray examination.