5.0 内視鏡施行の理由（REASONS FOR ENDOSCOPY）

[Last update 10.May 2002]

5.0 内視鏡施行の理由（REASONS FOR ENDOSCOPY）

5.1 扱われる範囲（Scope） These lists have been reviewed by the ASGE but there are some differences in use between the U.S. and the European community. The lists are provided and are being tested. In the U.S. Indications are often used in place of reasons for endoscopy. An Indication is used to define the reason for an endoscopy which complies with generally accepted standards of practice. There may be reasons for an endoscopy which are not Indications. For example, a patient may want to undergo annual colonoscopy for colorectal cancer surveillance even though there is no prior history of polyps or family history of colon cancer. The reason for colonoscopy is to exclude a tumor but there is no Indication. The ASGE Committee's recommended list of "Indications" was intended as a means of assessing the relevance and necessity for an endoscopic examination. This list had been devised on the basis of the appropriateness of an individual examination. While appreciating the reasons behind this decision, the Committee felt that it was more important to record why a particular examination had been undertaken rather than instruct users when an examination was acceptable. "Reasons for" have, therefore, been divided into: 1. Symptoms: to allow a user to record the symptoms for which an endoscopic examination is required. This is particularly important where a disease is difficult to define. 2. Diseases: this lists the common diseases for which an endoscopic examination may be required. These can be qualified by "Suspected...", "For exclusion of...", "For follow-up of..." or "For therapy of...". 3. Assessment of: this item was introduced in the "Reasons for" list in order to allow the recording of examinations performed to evaluate the status of a part of the GI tract before or after a surgical procedure, in the absence of a specific sign requiring the examination of this organ. 4. Diagnostic sampling: this was included as a "Reason for", as it was recognized that some examinations may only be performed to collect a sample. The lists proposed are provided for each type of examination performed. 5.2 検査の理由（Reasons for examination） 5.2.1 上部消化管内視鏡（Upper gastrointestinal endoscopy）. The following terms shall be used to describe the reasons for performing an upper gastrointestinal examination.

Table 16. 上部消化管検査の理由（Reasons for upper gastrointestinal examination）

`症状 (Symptoms)`
`腹部不快感/腹痛 (Abdominal distress/pain)`
`嚥下困難(Dysphagia)`
`吐血(Hematemesis)`
`下血(Melena)`
`胸やけ(Heartburn)`
`悪心/嘔吐(Nausea/Vomiting)`
`体重減少(Weight loss)`
`貧血(Anemia)`
`下痢(Diarrhea)`
`食欲不振`

`疾患(Diseases)`	`属性(Attribute)`
`腫瘍(Tumor)`	`疑い(Suspected)`
`胃食道逆流症(Gastro-esophageal reflux disease)`	`確定(Established)`
`潰瘍(Ulcer)`	`除外(Exclusion of)`
`胃炎(Gastritis)`	`経過観察(Follow-up of)`
`狭窄(Stenosis)`	`治療(For therapy of)`
`消化管出血 (Gastrointestinal bleeding)`	`記述する(Specify)`
`静脈瘤(Varices)`
`前癌性病変(Precancerous lesions)`
`異物(Foreign Body)`
`原発不明の転移(Metastasis of unknown orign)`
`その他(記述する)`

`評価(Assessment)`
`術前(Preoperative)`
`術後(Post-operative)`	`外科治療後`
	`内視鏡治療後`
`スクリーニング(Screening)`
`腫瘍の家族歴(Familial history of neoplasm)`
`検診異常`
`画像診断の異常 (Abnormal Imaging procedure)`	`記述する(Specify)`

`検体検査:記述する (Diagnostic sampling:specify)`

5.2.2 下部消化管内視鏡（Lower gastrointestinal endoscopy）. The following terms shall be used to describe the reasons for performing an lower gastrointestinal examination.

Table 17. 下部消化管検査の理由 (Reasons for lower gastrointestinal examination)

`症状 (Symptoms)`
`血便(Hematochezia)`
`出血源不明の下血(Melena of unknown origin)`
`下痢(Diarrhea)`
`腹部不快感/腹痛(Abdominal distress/pain)`
`便通異常(Modification of bowel habits)`
`貧血(Anemia)`
`体重減少(Weight loss)`

`疾患(Diseases)`	`属性(Attributes)`
`ポリープ(Polyps)`	`疑い(Suspected)`
`大腸癌(Colo-rectal cancer)`	`確定(Established)`
`結腸閉塞(Colonic obstruction)`	`除外(Exclusion of)`
`憩室(Diverticula)`	`経過観察(Follow-up of)`
`炎症性の腸疾患(Inflammatory Bowel Diseases:)`	`治療(For therapy of)`
`クローン病(Crohn's disease)`
`潰瘍性大腸炎(Ulcerative colitis)`
`腸捻転(Volvulus)`
`血管拡張症(Angioectasia)`
`虚血性大腸炎(Ischemic colitis)`
`偽膜性大腸炎`
`原因不明の転移(Metastasis of unknown origin)`
`その他(記述する)`

`評価(Assessment)`
`術前(Preoperative)`
`術後(Post-operative)`	`外科治療後`
	`内視鏡治療後`
`潜血(Occult blood loss)`
`スクリーニング(Screening)`
`腫瘍の家族歴(Familial history of neoplasms)`
`画像診断の異常(Abnormal Imaging procedure)`	`記述する(Specify)`

`検体検査:記述する (Diagnostic sampling:specify)`

5.2.3 ERCP（ERCP） The following terms shall be used to describe the reasons for performing an ERCP.

Table 18. ERCP検査の理由(Reasons for performing ERCP)

`症状 (Symptoms)`
`黄疸(Jaundice)`
`胆膵由来を疑う腹痛` `(Abdominal pain of suspected biliary or` `pancreatic origin)`

`生化学検査異常 (Biological abnormalities)`
`肝機能検査` `(Liver function tests)`
`膵検査(Pancreatic tests)`
`腫瘍マーカー異常`

`画像上の異常` `(Abnormal imaging` `procedure)`	`記述する(Specify)`

`疾患(Diseases)`	`属性(Attributes)`
`総胆管結石(Bile ducts stone)`	`疑い(Suspected)`
`胆嚢結石(Gallbladder stone)`	`確信(Established)`
`急性膵炎(Acute pancreatitis)`	`除外 (Exclusion of)`
`慢性膵炎 (Chronic` `pancreatitis)`	`経過観察 (Follow-up of)`
`乳頭部腫瘍` `(Periampullary tumor)`	`治療 (For therapy of)`
`膵/胆道腫瘍 (Pancreatic/biliary tumor)`
`胆管炎(Cholangitis)`
`膵・胆道嚢胞 (Biliary or pancreatic cysts)`
`胆道手術の合併症` `(Complication of previous` `biliary surgery)`
`非手術胆道処置の合併症` `(Complication of previous` `biliary non-surgical` `intervention)`
`ステント閉塞(Stent occlusion)`

`評価(Assessment)`
`術前(Preoperative)`
`術後(Post-operative)`
`診断的標本採取(Diagnostic` `sampling) :記述する(specify)`
`乳頭切開術(Sphincterotomy)`
`結石除去(Stone removal)`	`胆管､膵管`
`ステント留置(Stenting):膵管/胆管(biliary/pancreatic` `ducts)`
`ステント抜去` `(Stent removal or change)`
`拡張術(Dilatation):胆管/膵管部位` `(biliary/pancreatic location)`
`ドレナージ(Drainage):胆管/膵管(biliary, pancreatic)`
`嚢胞ドレナージ(Cyst drainage)`
`止血(Hemostasis)`
`膵胆道系精査`
`経口胆道鏡/膵管鏡`