Crohn病の内視鏡所見

Endoscopic Diagnosis of Crohn's Disease

Crohn病（CD）の内視鏡的特徴は，その自然史の中でいわゆる初期の病変であるアフタ様潰瘍（病変）が不整形潰瘍になり，さらにそれらが縦列傾向を示し，癒合して典型的な“縦走潰瘍”，“敷石像（敷石様外観）”に進展すると考えられている．さらに狭窄，瘻孔，膿瘍などの腸管合併症へと進行し，外科的治療が必要となる症例も多い．近年の内視鏡機器の進歩と診断技術が向上によりCDに対してより正確な診断と治療が可能となった．

　Aphthoid ulcer/lesion and discrete ulcer are typical early lesions for Crohn's disease. They progress to a longitudinal ulcer after several years, and, eventually, cause complications, such as, stricture, fistula and abscess.

　It has become possible to acquire detailed information of the small intestine because of the progress of various inspection devices and technology.

　Moreover, endoscopical dilatation of a severe stricture area is possible by using balloon endoscopy, and it increases the number of cases in which an operation can be avoided.