Department of Pediatrics, Sapienza University of Rome, Rome, Italy.
Gastrointest Endosc. 2012 Jan;75(1):80-6. doi: 10.1016/j.gie.2011.06.021.
Single-balloon enteroscopy (SBE) has not been reported in pediatric Crohn's disease (CD).
To determine technical performance, yield, safety, and clinical impact of SBE in pediatric patients with suspected and established CD.
Prospective, cohort study.
Academic tertiary-care referral center.
This study involved 16 patients (group A) with suspected CD and unspecific upper and lower GI endoscopy results and 14 patients (group B) with longstanding CD with previous surgery and showing signs unaccountable by conventional endoscopy. All underwent magnetic resonance imaging, and 14 patients in group A also underwent wireless capsule endoscopy.
SBE.
SBE diagnostic and therapeutic yield, technical performance, clinical impact, and safety.
In group A, SBE aided diagnosis of CD in 12 patients and eosinophilic enteropathy in 2 patients, whereas no lesions were found in 2 patients. WCE was diagnostic of CD in 3 patients, suggestive of CD in 7 patients, and unspecific in the remaining patients. In group B, SBE revealed moderate-to-severe disease activity in most patients, leading to the introduction of or change in biological therapy, with a marked decrease in the pediatric Crohn's disease activity index scores. SBE allowed successful dilation of small-bowel strictures in 2 patients in group A and 3 in group B. No complications occurred.
Small sample size, no direct comparison with imaging or other endoscopic techniques.
SBE is a useful and safe endoscopic procedure for evaluating the small bowel in pediatric patients with suspected or established CD. Not only does it allow a definite diagnosis of CD when the latter is uncertain, but it is also very effective in the management of small-bowel strictures, thus avoiding surgery. It may be helpful in redirecting therapy in selected CD patients.
单气囊小肠镜（SBE）在儿科克罗恩病（CD）中尚未有报道。
确定 SBE 在疑似和确诊的小儿 CD 患者中的技术性能、检出率、安全性和临床影响。
前瞻性队列研究。
学术性三级转诊中心。
本研究纳入了 16 例（A 组）疑似 CD 且上、下胃肠道内镜检查结果不明确的患者和 14 例（B 组）既往有手术史且常规内镜检查结果无法解释的长期 CD 患者。所有患者均接受了磁共振成像检查，其中 14 例 A 组患者还接受了无线胶囊内镜检查。
SBE。
SBE 的诊断和治疗检出率、技术性能、临床影响和安全性。
在 A 组中，SBE 辅助诊断 CD 患者 12 例，嗜酸性肠炎 2 例，2 例患者未见异常。WCE 诊断 CD 患者 3 例，提示 CD 患者 7 例，其余患者均无特异性。在 B 组中，SBE 发现大多数患者存在中重度疾病活动，导致生物治疗的引入或改变，小儿克罗恩病活动指数评分显著降低。SBE 成功扩张了 A 组的 2 例和 B 组的 3 例小肠狭窄。无并发症发生。
样本量小，未与影像学或其他内镜技术直接比较。
SBE 是一种有用且安全的内镜检查方法，可用于评估疑似或确诊的小儿 CD 患者的小肠。它不仅可以在 CD 不确定时做出明确诊断，而且在处理小肠狭窄方面非常有效，从而避免了手术。它可能有助于为选定的 CD 患者重新调整治疗方案。
