臨牀消化器内科 Vol.33 No.5(1)


特集名 緊急内視鏡の適応と実際
題名 消化器診療における緊急内視鏡の役割
発刊年月 2018年 05月
著者 春田 純一 名古屋第一赤十字病院消化器内科
著者 山口 丈夫 名古屋第一赤十字病院消化器内科
著者 土居崎 正雄 名古屋第一赤十字病院消化器内科
著者 鷲見 肇 名古屋第一赤十字病院消化器内科
著者 村手 健太郎 名古屋第一赤十字病院消化器内科
【 要旨 】 消化器領域における緊急内視鏡診断・治療を要するおもな疾患は,消化性潰瘍,静脈瘤破裂をはじめとする上部・下部消化管出血,消化管異物の除去,大腸癌による腸閉塞,S状結腸軸捻転,胆膵系では総胆管結石,悪性腫瘍による閉塞性黄疸が挙げられる.内視鏡技術・機材性能の向上により,多くの症例で内視鏡で治療を完結することが可能となっている.遭遇頻度の高い疾患を中心に緊急内視鏡治療の実例を示し,診断,治療のコツと留意点を概説する.
Theme Indications and Standards of Practice for Emergency Endoscopy
Title Role of Emergency Endoscopy in the Diagnosis and Treatment of Digestive Tract Diseases
Author Jun-ichi Haruta Japanese Red Cross Nagoya 1st Hospital, Department of Gastroenterology
Author Takeo Yamaguchi Japanese Red Cross Nagoya 1st Hospital, Department of Gastroenterology
Author Masao Doizaki Japanese Red Cross Nagoya 1st Hospital, Department of Gastroenterology
Author Hajime Sumi Japanese Red Cross Nagoya 1st Hospital, Department of Gastroenterology
Author Kentaro Murate Japanese Red Cross Nagoya 1st Hospital, Department of Gastroenterology
[ Summary ] The major digestive tract diseases that require emergency endoscopic diagnosis and treatment are digestive ulcers, upper and lower gastrointestinal bleeding including ruptured varices, foreign bodies of the digestive tract, intestinal obstruction secondary to colon cancer, axial torsion of the sigmoid colon, bile duct stones in the biliary tract, and/or obstructive jaundice secondary to malignant tumors. Following improvements in endoscopic technology and the use of better equipment, endoscopic treatment can be easily performed in several patients. I shall now present various cases to demonstrate the use of endoscopic therapy primarily for diseases that are commonly observed in clinical practice. Moreover, I shall outline tips to effectively diagnose and treat such patients with special attention to the important points that need to be noted.
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