| 特集名 | カプセル内視鏡の現況と最新動向 | |
|---|---|---|
| 題名 | カプセル内視鏡の意義と役割 (1) 原因不明の消化管出血患者に対するカプセル内視鏡の意義 | |
| 発刊年月 | 2015年 12月 | |
| 著者 | 小林 由佳 | 東京大学大学院医学系研究科消化器内科 |
| 著者 | 山田 篤生 | 東京大学大学院医学系研究科消化器内科 |
| 著者 | 小池 和彦 | 東京大学大学院医学系研究科消化器内科 |
| 【 要旨 】 | 上部および下部消化管内視鏡検査にて，出血源を同定できないような消化管出血を原因不明の消化管出血（OGIB）という．カプセル内視鏡は，低侵襲かつ診断能の高い検査であり，OGIB患者に対し現在広く使用されている．腹部造影CTやバルーン内視鏡などと組み合わせることで，さらに小腸疾患診断能は向上する．また，カプセル内視鏡施行のタイミングや便潜血検査も，小腸疾患診断能と関連があるということが報告されている．本稿では多角的に，OGIB患者に対するカプセル内視鏡の意義について概説する． | |
| Theme | Capsule Endoscopy -- Current States and the Latest Developments | |
|---|---|---|
| Title | Signification of Capsule Endoscopy for Patients with Obscure Gastrointestinal Bleeding | |
| Author | Yuka Kobayashi | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Atsuo Yamada | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Kazuhiko Koike | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| [ Summary ] | Obscure gastrointestinal bleeding (OGIB) is diagnosed in patients where the bleeding source cannot be identified on esophagogastroduodenoscopy or colonoscopy. OGIB is classified as either overt or occult OGIB. Occult OGIB is considered in patients with iron deficiency anemia and/or a positive fecal occult blood test (FOBT) result, whereas overt OGIB refers to clinically evident bleeding. Capsule endoscopy (CE) is now available for assessing small bowel diseases (SBDs) in patients with OGIB. Capsule endoscopy is noninvasive and has a high diagnostic yield for SBDs. The diagnostic yield of capsule endoscopy is further improved by combining it --with other modalities such as balloon enteroscopy and contrast‒enhanced CT scan of the abdomen. A shorter interval between bleeding and CE is reported to achieve a higher diagnostic yield for patients with overt OGIB. The prevalence of SBDs in occult OGIB was significantly higher in patients with positive FOBT result than in those with a negative test result. In this section, the significance and application of capsule endoscopy for patients with OGIB has been described based on various aspects. |
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