INTESTINE Vol.18 No.2(1-1)

特集名 炎症性腸疾患の画像診断modality
題名 大腸内視鏡 (1) 総論
発刊年月 2014年 03月
著者 河内 修司 松山赤十字病院胃腸センター
著者 松本 主之 岩手医科大学医学部内科学講座消化器内科消化管分野
【 要旨 】 大腸内視鏡検査は,炎症性腸疾患の診断,活動性評価,治療方針決定において必須の検査である.近年,潰瘍性大腸炎やクローン病における内視鏡的粘膜治癒は,その後の良好な臨床経過の予測因子の一つと考えられ,重要な治療評価項目となってきている.慢性持続性炎症を母地とする大腸腫瘍発生に対するサーベイランスにおいても他の検査とともに重要な位置を占める.また潰瘍性大腸炎では大腸全摘術後の回腸囊炎の診断や活動性評価,クローン病では腸管切除後の再発病変の評価や狭窄に対するバルーン拡張術にも用いられる.
Theme Imaging modalities for IBD
Title Role of colonoscopy in inflammatory bowel disease
Author Shuji Kochi Division of Gastroenterology, Matsuyama Red Cross Hospital
Author Takayuki Matsumoto Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University
[ Summary ] Colonoscopy is a mandatory procedure for the diagnosis and assessment of disease activity, and treatment of inflammatory bowel disease (IBD). Recently, mucosal healing as determined by colonoscopy in patients with ulcerative colitis (UC) and Crohn's disease (CD) has come to be considered predictive of favorable outcomes for patients with these diseases. Surveillance colonoscopy may permit earlier detection of colorectal cancer and dysplastic lesions in patients with long term IBD. Diagnosis of pouchitis after proctocolectomy requires confirmation of characteristic endoscopic and histological abnormalities in the ileal pouch. Furthermore, colonoscopy has become the gold standard for diagnosis of post operative recurrence of CD. Endoscopic dilation of stenosis in CD patients is a technique for the management of accessible short strictures. Colonoscopy seems to show great promise for the management of IBD.