| 特集名 | 小児の腹痛とその処置 -- 最新の捉え方 | |
|---|---|---|
| 題名 | 小児の消化管内視鏡診断と治療 | |
| 発刊年月 | 2005年 06月 | |
| 著者 | 米沢 俊一 | もりおかこども病院小児科 |
| 著者 | 井上 義博 | 岩手医科大学救急医学講座 |
| 著者 | 熊谷 秀規 | 岩手医科大学小児科学講座 |
| 著者 | 金浜 誠己 | もりおかこども病院小児科 |
| 著者 | 小西 峯生 | もりおかこども病院小児科 |
| 【 要旨 】 | 小児消化管内視鏡診断・治療においての留意点は体型に応じた内視鏡の機種選定，麻酔・鎮静法選択，小児に特有な疾患把握である．全例に鎮静・麻酔が必要であり，そのために全身状態管理医，内視鏡医，患児介添者，内視鏡技師の4人のスタッフが必要である．小児に特有な疾患として，上部消化管では肝外門脈閉塞症による食道静脈瘤，Helicobacter pylori菌感染による結節性胃炎，アレルギー紫斑病，食物アレルギーによる十二指腸炎がある．下部消化管では若年性ポリープ，アレルギー性直腸炎，結節性リンパ濾胞過形成がある．また，疾患の特徴として悪性疾患はほとんどまれで，遺伝性疾患と炎症・免疫疾患が主体であり，粘膜生検が診断の決め手になることが多い． 治療においては成人と同様な方法をとるが，管壁が薄いこと，薬剤注入量，空気挿入量に留意する必要がある． |
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| Theme | Abdominal Pain in Children : Current Clinical Management | |
|---|---|---|
| Title | Diagnostic and Therapeutic Endoscopy of Gastrointestinal Tract in Children | |
| Author | Shun-ichi Maisawa | Pediatric Division, Morioka Children's Hospital |
| Author | Yoshihiro Inoue | Department of Critical Care Medicine, Iwate Medical University |
| Author | Hideki Kumagai | Department of Pediatrics, Iwate Medical University |
| Author | Seiki Kanehama | Pediatric Division, Morioka Children's Hospital |
| Author | Mineo Konishi | Pediatric Division, Morioka Children's Hospital |
| [ Summary ] | Particular consideration should be paid to pediatric endoscopy, in terms of choice of endoscopes to correspond to pediatric physical size, method of sedation and anesthesia, and knowledge of pediatric diseases. Medical staff members including the anesthetist, the endoscopist, the patient care nurse and the endoscopic technologist are needed for the performance of pediatric endoscopy. The following diseases can be enumerated as defined in children : (1) esophageal varices caused by extrahepatic portal occlusion, (2) nodular gastritis due to Helicobacter pylori infection, (3) Henoch-Schönlein purpura, (4) duodenitis due to food allergies, (5) juvenile polyps, (6) allergic proctitis, and (7) nodular lymphoid hyperplasia. Differences between gastrointestinal diseases in children and adults are pointed out concerning pediatric cancer in the gastrointestinal tract which is extremely rare. Pediatric diseases are usually genetic, inflammatory and immune disease. For these reasons, mucosal biopsies are important for confirmation of diagnosis. The method of endoscopic treatment for pediatric patients is almost the same as for adults. However, the endoscopist should be cautious of the thin wall of the gastrointestinal tract, injection volume of therapeutic agents, and infusion volume of air during treatment. |
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