Nakamura Masanao, Niwa Yasumasa, Ohmiya Naoki, Arakawa Daigo, Honda Wataru, Miyahara Ryoji, Matsuura Tetsuo, Ando Takafumi, Maeda Osamu, Itoh Akihiro, Hirooka Yoshiki, Goto Hidemi
Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Eur J Gastroenterol Hepatol. 2007 Jul;19(7):595-8. doi: 10.1097/MEG.0b013e3280ec544c.
Small bowel tuberculosis is sometimes encountered in oriental countries, and because its symptoms are vague and present a nonspecific pattern, confirmative diagnosis is difficult to achieve. In 2001, two new innovative endoscopic techniques for the small bowel, video capsule endoscopy and double balloon enteroscopy, were introduced, thus advancing the diagnostic technology for small bowel disorders. Our asymptomatic patient with small bowel tuberculosis was diagnosed definitively using the combination of video capsule endoscopy and double balloon enteroscopy. The number of such cases will increase when those procedures become more widely used. At present, the endoscopic view of small bowel tuberculosis is difficult to differentiate from Crohn's disease and drug-induced enteropathy, but from now on it will be possible to distinguish them utilizing endoscopic and fluoroscopic images. On the basis of the characteristics of small bowel tuberculosis with its endoscopic images, referring to our case report and previous literature, we report a topical diagnostic procedure, the combination of video capsule endoscopy and double balloon enteroscopy.
小肠结核在东方国家时有发生,因其症状模糊且呈现非特异性模式,确诊困难。2001年,两种用于小肠的新型创新内镜技术——视频胶囊内镜和双气囊小肠镜被引入,从而推动了小肠疾病诊断技术的发展。我们的无症状小肠结核患者通过视频胶囊内镜和双气囊小肠镜联合检查得以明确诊断。当这些检查方法得到更广泛应用时,此类病例数量将会增加。目前,小肠结核的内镜表现难以与克罗恩病和药物性肠病相鉴别,但从现在起利用内镜和荧光镜图像将有可能区分它们。基于小肠结核的内镜图像特征,参考我们的病例报告及既往文献,我们报告一种局部诊断方法——视频胶囊内镜和双气囊小肠镜联合检查。