bougienage

ブジー挿置法

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/10 08:36:43」(JST)

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Esophageal dilatation is a therapeutic endoscopic procedure that enlarges the lumen of the esophagus.

Indications

It can be used to treat a number of medical conditions that result in narrowing of the esophageal lumen, or decrease motility in the distal esophagus. These include the following:

• Peptic stricture
• Schatzki rings
• Achalasia
• Scleroderma esophagus
• Rarely esophageal cancer

Types of dilators

There are three major classes of dilators:

• Mercury-weighted bougies are blindly inserted bougies placed into the esophagus by the treating physician. They are passed in sequentially increasing sizes to dilate the obstructed area. They must be used with precaution in patients with narrow strictures, as they may curl proximal to the obstruction. The most commonly used mercury weighted bougies are the Maloney bougie dilators.
• Bougie over guidewire dilators are used at the time of gastroscopy or fluoroscopy. An endoscopy is usually performed first to evaluate the anatomy, and a guidewire is passed into the stomach past the obstruction. This may also be done fluoroscopically. Bougies are again introduced—this time over the guidewire—in sequentially increasing sizes. The most commonly used bougie over guidewire dilators are the Savary or Savary–Gilliard dilators.
• Pneumatic dilatation or balloon dilatation is also typically done at the time of endoscopy or fluoroscopy. A balloon is inserted in the deflated form into the area of narrowing. It is then inflated with air to a certain pressure that is pre-set for a given circumference.

Complications

Complications of esophageal dilatation include the following:

• Odynophagia, or painful swallowing
• Hematemesis, or bloody vomit
• Esophageal perforation
• Mediastinitis

References

UpToDate Contents

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• 1. 小児における食道および消化管の異物 foreign bodies of the esophagus and gastrointestinal tract in children
• 2. 良性食道狭窄のマネージメント management of benign esophageal strictures
• 3. 食道輪および食道ウェブ esophageal rings and webs
• 4. アカラシアの治療の概要 overview of the treatment of achalasia
• 5. 成人における腐食性の食道損傷 caustic esophageal injury in adults

English Journal

• Challenges in oral drug delivery in patients with esophageal dysphagia.

• Kappelle WF1, Siersema PD1, Bogte A1, Vleggaar FP1.
• Expert opinion on drug delivery.Expert Opin Drug Deliv.2016 May;13(5):645-58. doi: 10.1517/17425247.2016.1142971. Epub 2016 Mar 22.
• INTRODUCTION: Esophageal dysphagia is a commonly reported symptom with various benign and malignant causes. Esophageal dysphagia can impede intake of oral medication, which often poses a major challenge for both patients and physicians. The best way to address this challenge depends of the cause of
• PMID 26781167

• Therapy of caustic ingestion: new treatment considerations.

• Shub MD1.
• Current opinion in pediatrics.Curr Opin Pediatr.2015 Oct;27(5):609-13. doi: 10.1097/MOP.0000000000000257.
• PURPOSE OF REVIEW: This review will focus on therapeutic considerations and recent advances in treatment of caustic ingestion injuries.RECENT FINDINGS: A retrospective study suggests that it may be safe to advance the endoscope beyond the first circumferential burn to allow for a more complete asses
• PMID 26196260

• Safe and effective management of esophageal coins in children with bougienage.

• Heinzerling NP1, Christensen MA1, Swedler R1, Cassidy LD1, Calkins CM1, Sato TT2.
• Surgery.Surgery.2015 Oct;158(4):1065-70; discussion 1071-2. doi: 10.1016/j.surg.2015.06.025. Epub 2015 Jul 31.
• BACKGROUND: Coins are the foreign body most commonly ingested in infants and children. Coins retained in the esophagus require intervention to prevent complications. Management of retained esophageal coins remains variable both between and within institutions. We hypothesize that the incorporation o
• PMID 26239181

Japanese Journal

• Total gastroesophageal dissociationを施行した続発性食道気管支瘻の1例

• 西 明,黒岩 実,鈴木 則夫
• 日本臨床外科学会雑誌 74(4), 912-916, 2013
• 症例は精神運動発達遅滞を有する5p-症候群の27歳男性．20歳頃から固形物摂取が困難となり，27歳時にコーヒー残渣様嘔吐と貧血が出現し当科紹介．食道裂孔ヘルニア，高度食道狭窄の診断で，噴門形成，胃瘻造設を施行．術後1カ月で食道ブジーを行ったが，狭窄は治療抵抗性であり，4回目のブジー時に食道気管支瘻が判明し保存的治療施行．一時瘻孔が閉鎖したが経過中に瘻孔再発し手術（中下部食道切除，瘻閉鎖，食道胃接合 …
• NAID 130004900990

• 直腸癌術後の膜様閉鎖に内視鏡的切開術が有用であった2例

• 林 裕子,千野 晶子,藤本 佳也,石川 寛高,岸原 輝仁,浦上 尚之,為我井 芳郎,五十嵐 正広,高橋 寛,上野 雅資
• 日本大腸肛門病学会雑誌 65(4), 219-223, 2012-04-01
• 直腸癌に対する肛門温存術後の吻合部に，狭窄を認める事がある．多くの狭窄例では，用指ブジーやバルーンを用いた内視鏡的拡張術で拡張が可能であり，吻合部が閉鎖まできたす症例は稀である．直腸癌術後の吻合部に膜様閉鎖をきたした例を経験した．症例1は術前化学放射線療法後で，肛門縁上の吻合部は完全に閉塞していたが，内視鏡直視下にて生検鉗子で把持したところ，やわらかく薄い膜であることから，膜様閉鎖であると判断し， …
• NAID 10030360099

• 高度瘢痕性気管支狭窄に対する小児用Dumon stent留置術

• 羽隅 透,佐藤 伸之,斎藤 泰紀,阿部 二郎,星 史彦,川村 昌輝,田中 遼太
• 気管支学 : 日本気管支研究会雑誌 34(1), 58-63, 2012-01-25
• 背景.気道狭窄に対するシリコンステント留置の有用性は確立されたものと言えるが,手技上硬性鏡の使用が要求されるため,その適応には制限が生じる.また術前処置として如何に狭窄部の開大を図り,ステント径に適合する内腔を確保するかが課題となる.症例.症例1は65歳,女性で結核性左主気管支狭窄症例.症例2は喉頭癌術後で永久気管瘻を有する64歳,男性で扁平上皮癌に対する右上葉管状切術後の吻合部肉芽狭窄症例.いず …
• NAID 110009327983

Related Links

• Definition of Bougienage - MedicineNet - Health and Medical ...

Bougienage: A procedure involving the use of a bougie. A bougie is a thin cylinder of rubber, plastic, metal or another material that a physician inserts into or though a body passageway, such as the esophagus, to widen the ...

• Bougienage | definition of bougienage by Medical dictionary

bougienage [boo″zhĕ-nahzh´] passage of a bougie. bou·gie·nage (bū-zhē-nahzh'), Examination or treatment of the interior of any canal by the passage of a bougie or cannula. bougienage A technique for treating corrosive burns of the ...

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リンク元

「ブジー挿置法」

「ブジー挿置法」

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英

bougienage

• 陣痛を誘発するために行われる手法であるが、現在行われていない。
• 子宮を刺激して陣痛を誘発する
• 禁忌は前置胎盤、前期破水。