Role of endoscopy in inflammatory bowel disease.
Role of endoscopy in inflammatory bowel disease.
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DOI：
10.1093/gastro/goy006
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发表时间：
2018-05
影响因子：
3.6
通讯作者：
Yaghoobi M
中科院分区：
文献类型：
--
作者：
Bharadwaj S;Narula N;Tandon P;Yaghoobi M
克罗恩病（CD）和溃疡性结肠炎（UC）构成炎症性肠病（IBD）的两种最常见的表型。回结肠镜活检被认为是诊断IBD的金标准。CD和UC的鉴别诊断是重要的，因为它们的内科和外科治疗方式和并发症可能不同。然而，由于缺乏CD或UC的诊断确定性，约15%的IBD患者被误诊为未分类的IBD。最近，人们越来越多地认识到治疗性内窥镜医师在IBD领域的作用。已开发出较新的成像技术，以帮助区分UC与CD。此外，内镜球囊扩张和支架植入术已成为CD狭窄管理的治疗设备的组成部分。在CD患者中，内镜超声被认为比磁共振成像更准确地检测肛周瘘。此外，与白光结肠镜相比，色素内镜有助于更早发现异型增生。因此，介入性内镜已成为IBD并发症诊断、治疗和管理的基石。近年来，内窥镜在IBD领域的作用已经从小肠成像发展到内窥镜球囊扩张和在异型增生监测中使用色素内窥镜。在这篇综述文章中，我们讨论了介入性内镜在IBD并发症的诊断、治疗和管理中的现有证据。
Crohn’s disease (CD) and ulcerative colitis (UC) constitute the two most common phenotypes of inflammatory bowel disease (IBD). Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of IBD. Differential diagnosis of CD and UC is important, as their medical and surgical treatment modalities and prognoses can be different. However, approximately 15% of patients with IBD are misdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or UC. Recently, there has been increased recognition of the role of the therapeutic endoscopist in the field of IBD. Newer imaging techniques have been developed to aid in the differentiation of UC vs CD. Furthermore, endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentarium of CD stricture management. Endoscopic ultrasound has been recognized as being more accurate than magnetic resonance imaging in detecting perianal fistulae in patients with CD. Additionally, chromoendoscopy may help to detect dysplasia earlier compared with white-light colonoscopy. Hence, interventional endoscopy has become a cornerstone in the diagnosis, treatment and management of IBD complications. The role of endoscopy in the field of IBD has significantly evolved in recent years from small-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia surveillance. In this review article, we discuss the current evidence on interventional endoscopy in the diagnosis, treatment and management of IBD compications.
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影响因子：
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作者：
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