Crohn's disease of the upper gastrointestinal tract: the value of endoscopic examination
Crohn's disease of the upper gastrointestinal tract: the value of endoscopic examination
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DOI：
10.1080/003655298750027308
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发表时间：
1998-01-01
影响因子：
1.9
通讯作者：
Lamers, CBHW
中科院分区：
文献类型：
--
作者：
Witte, AMC;Veenendaal, RA;Lamers, CBHW
上消化道受累被认为是克罗恩病(CD)的一种罕见表现。回顾研究报告的患病率数字为0.5%-13%。上消化道CD的诊断基于临床、放射学、内窥镜和组织学特征。与回顾研究相反，前瞻性研究显示，CD患者接受常规的内窥镜检查和活检，显示内窥镜和组织学异常的频率要高得多。由于幽门螺杆菌是胃炎最常见的病因，也是消化性溃疡最重要的病因，因此评估幽门螺杆菌在解释CD患者上消化道异常中的作用是很重要的。上消化道CD的治疗包括药物治疗和内窥镜或手术干预，实际上类似于远端CD的治疗。糖皮质激素仍是治疗上消化道CD最重要的药物。有时辅助治疗，如胃抗分泌药物和粘膜保护剂，是有益的。上消化道活检的内窥镜评估应该是CD患者工作的一部分。
The involvement of the upper gastrointestinal (GI) tract has been considered to be a rare manifestation of Crohn's disease (CD). Retrospective studies have reported prevalence figures of 0.5-13%. The diagnosis of CD of the upper GI tract is based on clinical, radiological, endoscopic and histologic features. In contrast to the retrospective studies, prospective studies, in which patients with CD underwent routine endoscopic evaluation with biopsies, revealed a much higher frequency of endoscopic and histologic abnormalities. Since Helicobacter pylori is the most frequent cause of gastritis and the most important etiologic factor in peptic ulcer disease, it is important to assess the contribution of H. pylori in the interpretation of the abnormalities observed in the upper GI tract in patients with CD. Therapy for CD of the upper GI tract consists of drug therapy and endoscopic or surgical interventions and is in fact similar to that for distal CD. Corticosteroids are still the most important drugs in the treatment of CD of the upper GI tract. Sometimes adjunctive therapy, e.g. gastric antisecretory drugs and mucosa protective agents, is beneficial. Endoscopic evaluation of the upper GI tract with biopsies should be part of the work-up of CD patients.