出血を主徴とする小腸非腫瘍性病変の診断と治療─血管性病変

Diagnosis and Treatment of Small Intestine Non-neoplastic Lesions Characterized by Bleeding

要旨●小腸疾患の診断能向上に伴い，小腸疾患に遭遇する頻度は格段に増している．小腸疾患においては，小腸出血は特に遭遇することの多い病態の一つであり，なかでも小腸血管性病変が原因として占める割合が高く，重要な疾患である．血管性病変は病理学的に大きく3つのカテゴリーに分類され，その病理学的分類とも整合性のとれた内視鏡分類を理解することは内視鏡医にとって必須となってきている．また，これらの病態を発見するためのストラテジーも重要であり，カプセル内視鏡検査，バルーン内視鏡検査，CTを組み合わせた病変の存在診断，局在診断も熟知する必要がある．

　With the improvement in the diagnostic ability for small intestine diseases, the number of diagnoses has increased than in the past. Among all small intestine diseases, bleeding is one of the most frequent and important state. In particular, vascular diseases are responsible for a large proportion of the incidences of bleeding from the small intestine.

　Vascular diseases are classified into three major pathological patterns and currently, the endoscopic classification of vascular diseases, consistent with the pathological classification, was published. We, endoscopists, must be proficient in this aspect. Furthermore, the strategy for detecting these diseases is also very important, and we must have good knowledge of the method involving the combination of capsule endoscopy, balloon assisted endoscopy, and computed tomography.