Li Yue, Wu Bin, Shen Bo
Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China.
Curr Gastroenterol Rep. 2012 Oct;14(5):406-13. doi: 10.1007/s11894-012-0282-4.
Approximately 20%-30% of patients with ulcerative colitis will eventually require colectomy despite recent advances in medical therapy. Ileal pouch-anal anastomosis has become the surgical treatment of choice. A subset of patients with ileal pouches can develop Crohn's disease or a Crohn's-disease-like condition of the ileal pouch after surgery. Diagnosis, differential diagnosis, and management of Crohn's disease of the ileal pouch have been challenging. A combined assessment of clinical history, endoscopy, histology, abdominal/pelvic imaging, and examination under anesthesia is often necessary for accurate diagnosis, disease classification, management, and prognosis. A multidisciplinary approach with gastroenterologists, colorectal surgeons, gastrointestinal pathologists, and radiologists is advocated.
尽管近年来药物治疗取得了进展，但约20%-30%的溃疡性结肠炎患者最终仍需要进行结肠切除术。回肠贮袋肛管吻合术已成为首选的外科治疗方法。一部分回肠贮袋患者术后可能会发生克罗恩病或类似克罗恩病的回肠贮袋病变。回肠贮袋克罗恩病的诊断、鉴别诊断及管理一直具有挑战性。准确的诊断、疾病分类、管理及预后往往需要综合评估临床病史、内镜检查、组织学检查、腹部/盆腔影像学检查以及麻醉下检查。提倡采用胃肠病学家、结直肠外科医生、胃肠病理学家和放射科医生的多学科方法。
