| 特集名 | 小児の消化器内視鏡診療 | |
|---|---|---|
| 題名 | 小児の大腸疾患 | |
| 発刊年月 | 2015年 03月 | |
| 著者 | 清水 泰岳 | 国立成育医療研究センター消化器科 |
| 【 要旨 】 | 小児でも，血便や難治性の下痢・腹痛の精査や炎症性腸疾患，消化管ポリポーシスの診断・治療などを目的として大腸内視鏡検査が行われる．安全な検査のために，適切なスコープを選択し，全身麻酔や鎮静薬を併用することが重要である． 小児では，炎症性腸疾患の非典型例や好酸球性腸炎など，内視鏡所見が正常な部位も含め，組織生検を複数の部位から採取することで診断に重要な情報が得られることも少なくない．また，腸炎症状が免疫不全症の一症状である場合もあり，小児特有の疾患を含めた幅広い鑑別が必要である．本稿では，小児期に血便や難治性の下痢・腹痛をきたす代表的な大腸疾患について概説した． |
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| Theme | Gastrointestinal Endoscopy in Children | |
|---|---|---|
| Title | Colonoscopy and Colonic Disorder in Childhood | |
| Author | Hirotaka Shimizu | Division of Gastroenterology, National Center for Child Health and Development |
| [ Summary ] | Colonoscopy (CS) is useful for the evaluation of hematochezia, intractable diarrhea, and abdominal pain in pediatric patients. CS is also performed to diagnose or evaluate inflammatory bowel disease and colonic polyps, among other conditions. The selection of an appropriate scope size is important when performing CS in pediatric patients, and general anesthesia or sedation is often used according to the patient's age and condition. Endoscopic findings of pediatric colonic disorders may differ from those of adult disorders. To enhance the diagnostic value of CS, mucosal biopsies from each part of the colon are recommended, regardless of the endoscopic findings. Moreover, patients with primary immune deficiency (PID) may develop colitic symptoms, and therefore PID should be excluded, especially in cases of early-onset enterocolitis or those with a history of repeat infections. In this chapter, the endoscopic findings of typical or rare pediatric colonic disorders will be presented. |
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