Nomura Yoshiki, Moriichi Kentaro, Fujiya Mikihiro, Okumura Toshikatsu
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan.
Clin J Gastroenterol. 2017 Aug;10(4):289-296. doi: 10.1007/s12328-017-0759-7. Epub 2017 Jul 10.
Crohn's disease (CD) is a type of chronic inflammatory bowel disease (IBD) associated with ulceration, and the main foci of the inflammation in CD patients are typically the terminal ileum and colon. However, in the upper gastrointestinal tract (GIT), including the esophagus, stomach and duodenum, inflammatory lesions are also detected as well, with a relatively high frequency (30-75%). Recent advances in imaging modalities, including endoscopy, have aided in the diagnosis of CD. Various lesions, including aphtha, erosion, ulcers, bamboo-joint-like appearance and notch-like appearance, are detected in the upper GI of CD patients. Of these lesions, the bamboo-joint-like appearance in the gastric cardiac region and notch-like appearance in the second portion of the duodenum are highly specific for CD, regardless of the disease activity at other sites. These two findings, particularly a bamboo-joint-like appearance, have therefore been considered as potential biomarkers for CD. Although proton pump inhibitors (PPIs) are administered as an initial treatment for upper GIT lesions of CD, the efficacy of this treatment remains controversial. The administration of mesalazine, steroids, immunosuppressant and biologic agents is expected to be effective for treating such lesions.
克罗恩病（CD）是一种与溃疡相关的慢性炎症性肠病（IBD），CD患者炎症的主要病灶通常是回肠末端和结肠。然而，在上消化道（GIT），包括食管、胃和十二指肠，也能检测到炎症性病变，且频率相对较高（30%-75%）。包括内镜检查在内的成像方式的最新进展有助于CD的诊断。在CD患者的上消化道中可检测到各种病变，包括口疮、糜烂、溃疡、竹节样外观和切迹样外观。在这些病变中，胃贲门区的竹节样外观和十二指肠第二部的切迹样外观对CD具有高度特异性，与其他部位的疾病活动无关。因此，这两个发现，尤其是竹节样外观，被认为是CD的潜在生物标志物。尽管质子泵抑制剂（PPI）作为CD上消化道病变的初始治疗药物，但这种治疗的疗效仍存在争议。美沙拉嗪、类固醇、免疫抑制剂和生物制剂的给药有望有效治疗此类病变。
