Tacla M
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia, IBEPEGE.
Arq Gastroenterol. 1990 Jul-Sep;27(3):132-6.
The author's experience with 42 colonoscopies in 41 patients with barium enema diagnosis of Crohn's disease is presented. The radiologic, endoscopic, histologic and surgical results are compared. According to radiological localization, the patients were classified in these groups: anorectal (9.7%), colic (51.2%) and ileocolic (39.1%). In 34 patients (80.9%) the endoscopic appearance was compatible with Crohn's disease, and in 24 (70.5%) the histologic examination confirmed the diagnosis. Endoscopic findings were as follows: segmental lesions in 34 (100%), aphthous ulcers in 18 (52.9%), cleft-like ulceration in 24 (70.5%) and cobblestone mucosa in 28 (82.3%). In 8 patients where endoscopy was not suggestive of Crohn's disease, the histologic examination was also negative, showing that colonoscopy was better than barium enema. Twenty patients with endoscopic diagnosis of Crohn's disease were operated and the diagnosis was confirmed in all. Endoscopic biopsies were positive in 12 (60%) of these operated patients. The author concludes that the endoscopic diagnosis of Crohn's disease can be made regardless of biopsy results.
本文介绍了作者对41例经钡剂灌肠诊断为克罗恩病的患者进行42次结肠镜检查的经验。对放射学、内镜检查、组织学和手术结果进行了比较。根据放射学定位，患者被分为以下几组：肛门直肠型（9.7%）、结肠型（51.2%）和回结肠型（39.1%）。34例患者（80.9%）的内镜表现符合克罗恩病，24例患者（70.5%）的组织学检查确诊。内镜检查结果如下：节段性病变34例（100%），阿弗他溃疡18例（52.9%），裂隙样溃疡24例（70.5%），鹅卵石样黏膜28例（82.3%）。8例内镜检查未提示克罗恩病的患者，组织学检查也为阴性，表明结肠镜检查优于钡剂灌肠。20例经内镜诊断为克罗恩病的患者接受了手术，所有患者均确诊。这些接受手术的患者中，12例（60%）内镜活检呈阳性。作者得出结论，无论活检结果如何，均可进行克罗恩病的内镜诊断。
