Lorenzo-Zúñiga Vicente, García-Planella Esther, Moreno De Vega Vicente, Domènech Eugeni, Boix Jaume
Unidad de Endoscopias, Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
Gastroenterol Hepatol. 2012 Jun-Jul;35(6):404-10. doi: 10.1016/j.gastrohep.2011.12.008. Epub 2012 Feb 16.
Luminal stenosis is frequent in Crohn's disease (CD) due to transmural involvement. Before any endoscopic treatment, the presence of neoplastic stenosis should always be excluded. Endoscopic balloon dilatation has been used in several series to treat benign stenosis, mainly in CD with involvement of the distal ileon, colon or surgical anastomosis, with success rates of 51% to 85%, although recurrence is high. The concomitant use of injected steroids (triamcinolone) after endoscopic dilatation produces longer-lasting results, but there are few published reports. In patients with luminal stenosis refractory to conventional endoscopy, three emerging techniques may be useful: self-expanding metallic stents, biodegradable endoprostheses and intralesional infliximab injection.
由于透壁性病变，克罗恩病（CD）常出现管腔狭窄。在进行任何内镜治疗之前，应始终排除肿瘤性狭窄的存在。内镜下球囊扩张已在多个系列研究中用于治疗良性狭窄，主要用于远端回肠、结肠或手术吻合口受累的CD，成功率为51%至85%，尽管复发率较高。内镜扩张后同时注射类固醇（曲安奈德）可产生更持久的效果，但发表的报告较少。对于传统内镜治疗无效的管腔狭窄患者，三种新兴技术可能有用：自膨式金属支架、可生物降解的内置假体和病灶内注射英夫利昔单抗。
