INTESTINE Vol.17 No.4(1-3)


特集名 回盲部潰瘍性病変
題名 [総論] (3) 回盲部潰瘍性病変における鑑別診断の進め方
発刊年月 2013年 08月
著者 小林 清典 北里大学東病院消化器内科
著者 大岡 正平 北里大学東病院消化器内科
著者 迎 美幸 北里大学東病院消化器内科
著者 横山 薫 北里大学東病院消化器内科
著者 佐田 美和 北里大学東病院消化器内科
著者 小泉 和三郎 北里大学東病院消化器内科
【 要旨 】 回盲部は,原因が特定できる特異性腸炎から原因が不明の非特異性腸炎まで,多くの炎症性腸疾患の好発部位であり,潰瘍を伴うことも多い.回盲部潰瘍を伴う炎症性腸疾患の鑑別診断においては,まず当を得た問診や診察,臨床検査を行う必要があり,一部の感染性腸炎は診断が可能である.しかし多くの炎症性腸疾患は,大腸内視鏡や生検組織の病理検査や培養検査で診断を確定する.とくに内視鏡検査では,回盲部を含む腸管病変の広がり,潰瘍の数や形態,周囲粘膜の変化などに着目する必要がある.
Theme Ulcerative lesions in the ileocecal region
Title Procedures for differential diagnosis of ulcerative lesions in ileocecum
Author Kiyonori Kobayashi Department of Gastroenterology, Kitasato University East Hospital
Author Shouhei Ooka Department of Gastroenterology, Kitasato University East Hospital
Author Miyuki Mukae Department of Gastroenterology, Kitasato University East Hospital
Author Kaoru Yokoyama Department of Gastroenterology, Kitasato University East Hospital
Author Miwa Sada Department of Gastroenterology, Kitasato University East Hospital
Author Wasaburo Koizumi Department of Gastroenterology, Kitasato University East Hospital
[ Summary ] The ileocecum is a common site of many inflammatory bowel diseases, ranging from specific enteritis with identifiable causes to non-specific enteritis of unknown origin. There are often associations with ulcer formation. Differential diagnosis requires appropriate interviews, medical examinations, and laboratory tests. Some cases of infectious enteritis can be diagnosed at this point. However, many cases of inflammatory bowel disease associated with ileocecal ulcers may be definitively diagnosed on the basis of endoscopic findings and the results of pathological examinations of biopsy specimens and culture testing. When conducting endoscopic examinations particular care should be paid to findings such as the spread of intestinal lesions, including assessment of the ileocecal region, the number and shape of ulcers, and changes in the surrounding mucosa.
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