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繰り返す小腸出血に対して複数回のカプセル内視鏡をガイドにダブルバルーン内視鏡で治療した1例
藤森 俊二, 山田 祐希江, 高橋 陽子, 江原 彰仁, 小林 剛, 三井 啓吾, 米澤 真興, 田中 周, 辰口 篤志, 坂本 長逸
日本医科大学大学院医学研究科病態制御腫瘍内科学
Usefulness of Plural Capsule Endoscopies and Double Balloon Endoscopies for Treatment of Obscure Gastrointestinal Bleeding
Shunji Fujimori, Yukie Yamada, Yoko Takahashi, Akihito Ehara, Tsuyoshi Kobayashi, Keigo Mitsui, Masaoki Yonezawa, Shu Tanaka, Atsushi Tatsuguchi and Choitsu Sakamoto
Department of Pathophysiological Management/Medical Oncology, Graduate School of Medicine, Nippon Medical School
We report on a 70-year-old man with recurrent bloody bowel discharge. We detected angiectasia at the distal ileum at initial capsule endoscopy. The angioectasia was treated with double balloon endoscopy. After treatment, bloody bowel discharge recurred. At a second capsule endoscopy after treatment of the distal ileum with double balloon endoscopy, another angiectasia and a bleeding ulcer were detected on the proximal jejunum. The bleeding ulcer was re-treated with double balloon endoscopy. After re-treatment, bloody bowel discharge again recurred. At a third capsule endoscopy, active bleeding was detected at the proximal jejunum. We were then able to diagnose the angiectasia on the proximal jejunum detected at the second capsule endoscopy and to determine that it was the source of bleeding. The angiectasia was detected and was treated with double balloon endoscopy. After treatment, the bloody bowel discharge has not recurred. We should carefully treat patients with multiple angiectasias, because most angiectasias can be sources of bleeding.
日医大医会誌 2009; 5(4), 221-224
Key words
capsule endoscopy, double balloon endoscopy, angioectasia, obscure gastrointestinal bleeding
Correspondence to
Shunji Fujimori, Department of Pathophysiological Management/Medical Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan
E-mail：s-fujimori@nms.ac.jp
受付：2009年4月22日 受理：2009年5月18日 |
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