著者

林 重之 星野 洋一 町田 守也 大木 一郎 高橋 俊行

出版者

一般社団法人 日本消化器内視鏡学会 関東支部

雑誌

Progress of Digestive Endoscopy (ISSN:13489844)

巻号頁・発行日

vol.67, no.2, pp.70-71, 2005-11-25 (Released:2013-11-21)

参考文献数

6

被引用文献数

1

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症例は31歳男性。精神遅滞で異食の傾向にあった。嘔吐,腹痛を主訴に近医受診。腹部単純レントゲン検査にて腹腔内に異物を認め当院へ入院した。上部消化管内視鏡検査では胃内の食物残渣に埋もれる複数の金属片が存在した。金属片は幅5mm,長径は様々であり辺縁は不整で一部は鋭利で噛み切って誤飲したものと推測した。消化管損傷や鉛片の可能性を考慮し内視鏡的にすべて摘除した。これらの金属片は入所施設のカーテン内のおもりとして使用されている鉛片であった。その後外来にて経過を観察するも原因不明の腹痛と倦怠感,貧血の進行を認め意識消失にて再入院となった。経過から鉛中毒を疑い血中鉛濃度を測定したところ84µg/dlと高値を示し鉛中毒と診断した。現在までに誤飲による鉛中毒の報告例はなく,興味ある症例と考え報告する。

著者

中原 朗 大木 一郎

出版者

一般社団法人 日本消化器内視鏡学会

雑誌

日本消化器内視鏡学会雑誌 (ISSN:03871207)

巻号頁・発行日

vol.18, no.5, pp.727-745, 1976

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High frequency oscillators have been developed and utilized for endoscopic polypectomy. Animal experiments were performed before applying them clinical trials. The results obtained from animal experiments and the findings by clinical trials were reported.1. Among oscillators, a transistor type which can provide a regular wave seemed to be most suitable. One with a built-in timer as a safety device is preferable.2. Degree of changes in the mucous membranes caused by high frequency current were almost proportional to the intensity and time of flow of electric current, however they were inversely proportional to the size of the area of the mucous membrane where an electrode were attached.3. Pathological study showes that changes in the tissues induced by coagulating wave sometimes continued to proceed over 1-2 weeks. Therefore, while performing polypectomy it is desirable to try to leave a polyp root by 3-5 mm in length.4. The size of a postoperative ulceration and the days required for its healing were dependent upon the thickness of pedicle, the duration of current flowed, and the place where the snare was set.5. Postoperative bleeding sometimes occured in cases in which the polyp had been removed with incomplete coagulation.6. Endoscopic polypectomy could be a perfect biopsy method which can cover demerits of usual biopsy methods. Further histological studies on removed polyps could provide the in formation for the definitive treatment of malignant polyp.7. We believe that there would be no accidental complications with enough understandings of properties of cutting and coagulating wave.