2013年10月19日掲載




Non-lifting signは永遠なり。Jet sign?

2011年に米国消化器病学会機関紙のGastroenterologyに、

オーストラリアからの論文で、Nonlifting signについての記載あり。

Gastroenterology. 2011 Jun;140(7):1909-18.

Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia.

Moss A, Bourke MJ, Williams SJ, Hourigan LF, Brown G, Tam W, Singh R, Zanati S, Chen RY, Byth K.

Department of Gastroenterology and Hepatology, Westmead Hospital, and Department of Biostatistics, School of Public Health, University of Sydney, Sydney, Australia.

その図がこれである。

A previous attempt at resection causes submucosal fibrosis and increases the risk of EMR failure. (A) Attempted submucosal injection results in the jet sign, where the fluid sprays back into the lumen at high pressure as it is injected. Submucosal fibrosis has obliterated the submucosal space, resulting in the jet sign, and nonlifting of the lesion. (B and C) Submucosal fibrosis is visible endoscopically during EMR. The white tissue bands are fibrotic deposits caused by electrocautery during the previous resection. (D) Fibrosis is visible histologically with H&E staining of the EMR specimen.

ＥＭＲで切除する前に生検など行えば、繊維化を生じてnon-lifting signやジェットsign

を生じて切除されにくくなる。

そうか、粘膜下層に注入されないで、液体が跳ね返ってくることを「ジェットサイン」と呼んでいるのか。。。。