潰瘍性大腸炎の内視鏡所見

Endoscopic Diagnosis for Ulcerative Colitis

要旨●活動期潰瘍性大腸炎（ulcerative colitis ; UC）の典型的な内視鏡像は，直腸から連続したびまん性の炎症所見（血管透見像消失，細顆粒状粘膜，びらん，潰瘍）である．また，寛解期UCの内視鏡所見は活動期の炎症の程度によって異なった所見を呈する．炎症の程度が低い場合には，寛解期粘膜の判定に拡大内視鏡観察も有用である．MES（Mayo endoscopic subscore）やUCEIS（ulcerative colitis endoscopic index of severity）を用いて内視鏡的活動性を客観的に評価することが可能である．UCは除外診断のため，鑑別が必要な炎症性腸疾患の内視鏡所見も熟知しておく必要がある．

　On endoscopy, active ulcerative colitis exhibits diffuse inflammatory mucosa（loss of vascular pattern, granular and fragile mucosa, erosions, and ulcerations）that extends from the rectum. In contrast, endoscopic findings of ulcerative colitis in remission differ depending on the degree of inflammation during the active phase. When the degree of inflammation is low, magnifying endoscopy is useful for effectively visualizing the mucosa（villi-and honeycomb-like appearance）. The Mayo endoscopic subscore and ulcerative colitis endoscopic index of severity can be used to objectively evaluate endoscopic activity. Because ulcerative colitis is a diagnosis based on exclusion, familiarity is necessary with the endoscopic findings of various inflammatory bowel diseases requiring differentiation.