炎症性腸疾患の画像所見と鑑別診断—縦走潰瘍

Endoscopic Diagnosis of Longitudinal Ulcers

要旨●縦走潰瘍を来す代表的な疾患はCrohn病（CD）であり，診断基準の主要所見として取り上げられている．典型的な縦走潰瘍や敷石像を認めれば，CDの確定診断が可能であるが，縦走潰瘍を呈する疾患は少なくないため，患者背景，臨床経過，各種画像検査さらに病理組織学的所見を加味した鑑別診断が重要である．本稿では縦走潰瘍を来しうる疾患について，画像所見の特徴や鑑別のポイントを中心に概説する．

　Crohn's disease is a predominant disease that causes longitudinal ulcers, and endoscopic assessment alone may be helpful in providing a definitive diagnosis. However, in case of other diseases that require differentiation of longitudinal ulcers, it is often difficult to reach a definitive diagnosis just on the basis of endoscopic assessment. Parameters such as age, onset of symptoms, complications, clinical course, drug history, blood data, ulcer occurrence sites, surrounding background mucosal condition, and other imaging test data, including X-rays, pathological tests, bacterial tests, should also be analyzed. It is critical to comprehensively consider all the abovementioned information prior to arriving at a diagnosis.