内視鏡的色素撒布が診断上有効であった大腸疾患症例

Effective Case of Colon Disease by Methylene-blue Spraying Method

　胃粘膜に青色系の色素を撒布し，胃粘膜の凹凸をはっきりさせ，内視鏡の微細診断に応用したのは津田¹⁾であるが，その後，食道²⁾や十二指腸球部³⁾や大腸^4)～8)にも応用されるようになった．

　色素撒布の応用に，単に溝に色素を付着させ凹凸の変化をはっきりさせるだけでなく，病変に対する着色性（生体染色）による性状の鑑別診断⁹⁾¹⁰⁾や，吸収の速度から機能的診断に用いるものもいる¹¹⁾¹²⁾．

　1. Methylene-blue spraying method is easy to reveal innominant grooves on the colon mucosa, and effective for endoscopic diagnosis of the followings that:

　a. normal colon mucosa,

　b. remission stage of ulcerative colitis,

　c. bounds of the lesion,

　d. lymphfolliculosis,

especially, effective for remission stage of ulcerative colitis.

　2. Magnifying colono-fyberscope (FCS-ML) has been reformed by Machida Company. Its maximum magnifying power is 30 times. It makes us observe the pits of Lieberkuhn easily after methylene-blue sprayed colon mucosa.

　Effective points of methylene-blue sprayed method.

　(Fig. 1) Remission stage of ulcerative colitis. Abnormal grooves and small color flecks are noticed.

　(Fig. 2) Colon tuberculosis. Innominant grooves are noticed in normal mucosa and make bound to the lesion.

　(Fig. 3) Lymph-follicules are revealed cleary in the methylene-blue sprayed part.

　(Fig. 4) This picture, using magnifying colono-fiberscope, shows the pits of Lieberkuhn clearly.

　(Fig. 5) Specification of magnifiing colono-fiber-scope.