Girelli Carlo Maria
AO Ospedale di Circolo di Busto Arsizio, Presidio di Busto Arsizio.
Recenti Prog Med. 2011 Jun;102(6):238-45. doi: 10.1701/893.9841.
Capsule endoscopy appropriateness in Crohn's disease.The incidence of Crohn's disease is steadily growing in western countries and the diagnosis is still delayed from symptoms onset by several years. Up to one third of patients have exclusive disease location in the small bowel, the tract less accessible to conventional diagnostic visualization. In the last decade, astonishing improvements in radiologic and endoscopic imaging allowed to better diagnose small bowel Crohn's disease. In particular, capsule endoscopy is a high sensitive tool in diagnosing subtle inflammatory lesions of the mucosa, but retention risk and low specificity limit its use in this setting. The present review provides a critical evaluation of the published studies addressed to the diagnostic role of small bowel capsule endoscopy in established, suspect, operated Crohn's disease and unclassified inflammatory bowel disease: in an attempt to help the clinician to utilize capsule endoscopy properly in the different clinical scenarios associated to inflammatory bowel disease.
胶囊内镜在克罗恩病中的适用性。在西方国家,克罗恩病的发病率正在稳步上升,且从症状出现到确诊仍会延迟数年。高达三分之一的患者疾病仅局限于小肠,而传统诊断可视化手段较难触及该部位。在过去十年中,放射学和内镜成像技术取得了惊人的进展,使得小肠克罗恩病能够得到更好的诊断。特别是,胶囊内镜是诊断黏膜细微炎症性病变的高灵敏度工具,但滞留风险和低特异性限制了其在这种情况下的应用。本综述对已发表的关于小肠胶囊内镜在确诊、疑似、接受手术治疗的克罗恩病以及未分类的炎症性肠病中的诊断作用的研究进行了批判性评估:旨在帮助临床医生在与炎症性肠病相关的不同临床场景中正确使用胶囊内镜。