Upper gastrointestinal Crohn's disease
Upper gastrointestinal Crohn's disease
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DOI：
10.1159/000111028
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发表时间：
2007-01-01
期刊：
影响因子：
3.2
通讯作者：
Froehlich, Florian
中科院分区：
文献类型：
--
作者：
Mottet, Christian;Juillerat, Pascal;Froehlich, Florian
克罗恩病的症状性胃十二指肠表现是罕见的，只有不到4%的患者有临床症状。然而，在20%的内镜检查和高达40%的组织学检查病例中可发现胃十二指肠受累，最常见的是幽门螺杆菌阴性的局灶性胃炎，通常发生在伴有远端回肠疾病的患者中。在实践中，除了存在梗阻性胃十二指肠症状外，伴随的远端克罗恩病的活动通常决定了治疗的适应症。由于可用的数据很少，可以正确地说，局部胃十二指肠疾病应采用用于更远端疾病的标准药物治疗，但具有pH依赖性释放的柳氮磺胺吡啶和美沙拉秦的盖伦制剂除外。梗阻症状的出现需要积极的治疗。如果类固醇和免疫调节药物治疗不能缓解症状，球囊扩张和手术是可以考虑的选择。版权所有（C）2008 S. Karger AG，巴塞尔。
Symptomatic gastroduodenal manifestations of Crohn's disease are rare, with less than 4% of patients being clinically symptomatic. Gastroduodenal involvement may, however, be found endoscopically in 20% and in up to 40% of cases histologically, most frequently as Helicobacter pylori-negative focal gastritis, usually in patients with concomitant distal ileal disease. In practice, the activity of concomitant distal Crohn's disease usually determines the indication for therapy, except in the presence of obstructive gastroduodenal symptoms. With the few data available, it seems correct to say that localized gastroduodenal disease should be treated with standard medical therapy used for more distal disease, with the exception of the galenic formulation of sulfasalazine and mesalazine with pH-dependent release. The presence of symptoms of obstruction needs aggressive therapy. If medical therapy with steroids and immunomodulatory drugs does not alleviate the symptoms, balloon dilation and surgery are the options to consider. Copyright (C) 2008 S. Karger AG, Basel.