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소장내시경 적응증: 어떤 환자에게 소장내시경을 권유해야 하나?

Indications for Enteroscopy: Which Patients Should Be Recommended for Enteroscopy?

최황
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2011.03|Clinical Endoscopy|제42권 제3호|pp. 137-142

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참고문헌

키워드

크론병Crohn's diseaseTumor소장종양Small intestineObscure gastrointestinal bleedingEnteroscopy원인불명 위장관 출혈소장내시경
주제분류내과학

초록

풍선보조 소장내시경은 전체 소장을 검사할 수 있는 새로운 방법이다. 소장내시경은 조직을 얻을 수 있고 세밀한 영상을 획득할 수 있으며, 지혈, 확장, 폴립절제술과 같은 내시경 치료가 가능하다. 소장내시경의 적응증은 원인불명의 위장관 출혈, 염증성 장질환의 소장침범, 소장종양이나 폴립증의 검사, 삽입곤란 대장내시경 등이다. 따라서 원인불명의 소장 출혈이 반복되는 환자, 소장 크론병이 의심되는 환자, 영상 검사에서 소장종양이 의심되는 환자, 가족선종폴립증 및 포이츠-예거증후군에서 소장내시경을 권유하여야 한다. 만성 복통이나 설사가 지속적 또는 반복적으로 있으면서 염증 지표들이 증가된 환자에서 소장내시경을 고려해 볼 수 있다. 또한 소장내시경의 금기증, 합병증, 제한점에 대하여도 알고 있어야 한다.

Abstract

Balloon-assisted endoscopy (double-balloon or single-balloon endoscopy) is a novel method used to examine the entire small bowel. Enteroscopy has advantages in that tissues can be obtained to get a detailed image, and it is feasible for endoscopic treatments such as hemostasis, dilatation, and polypectomy. Indications for enteroscopy are obscure gastrointestinal bleeding, small bowel involvement due to inflammatory bowel disease, an investigation of a small bowel tumor or polyposis, and difficulty of a colonoscopy. Enteroscopy should be recommended to patients with recurrent mid-gut bleeding of obscure origin, suspected Crohn's disease, suspicious small bowel tumor on abnormal imaging, and surveillance of polyposis syndrome including familial adenomatous polyposis and Peutz-Jeghers syndrome. We may consider enteroscopy in patients with chronic abdominal pain or diarrhea and increased inflammatory markers. We must also understand the contraindications, complications, and limitations of enteroscopy.

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