Rosa Bruno, Pinho Rolando, de Ferro Susana Mão, Almeida Nuno, Cotter José, Saraiva Miguel Mascarenhas
Gastroenterology Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal.
Gastroenterology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
GE Port J Gastroenterol. 2015 Oct 1;23(1):36-41. doi: 10.1016/j.jpge.2015.08.004. eCollection 2016 Jan-Feb.
The small bowel is affected in the vast majority of patients with Crohn's Disease (CD). Small bowel capsule endoscopy (SBCE) has a very high sensitivity for the detection of CD-related pathology, including early mucosal lesions and/or those located in the proximal segments of the small bowel, which is a major advantage when compared with other small bowel imaging modalities. The recent guidelines of European Society of Gastrointestinal Endoscopy (ESGE) and European Crohn's and Colitis Organisation (ECCO) advocate the use of validated endoscopic scoring indices for the classification of inflammatory activity in patients with CD undergoing SBCE, such as the Lewis Score or the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI). These scores aim to standardize the description of lesions and capsule endoscopy reports, contributing to increase inter-observer agreement and enabling a stratification of the severity of the disease. On behalf of the (GEPID) - Portuguese Small Bowel Study Group, we aimed to summarize the general principles and clinical applications of current endoscopic scoring systems for SBCE in the setting of CD, covering the topic of suspected CD as well as the evaluation of disease extent (with potential prognostic and therapeutic impact), evaluation of mucosal healing in response to treatment and evaluation of post-surgical recurrence in patients with previously established diagnosis of CD.
绝大多数克罗恩病（CD）患者的小肠都会受到影响。小肠胶囊内镜检查（SBCE）对检测CD相关病变具有很高的敏感性，包括早期黏膜病变和/或位于小肠近端的病变，与其他小肠成像方式相比，这是一个主要优势。欧洲胃肠内镜学会（ESGE）和欧洲克罗恩病和结肠炎组织（ECCO）最近的指南提倡使用经过验证的内镜评分指数对接受SBCE的CD患者的炎症活动进行分类，如刘易斯评分或胶囊内镜克罗恩病活动指数（CECDAI）。这些评分旨在规范病变描述和胶囊内镜检查报告，有助于提高观察者间的一致性，并能够对疾病严重程度进行分层。代表葡萄牙小肠研究组（GEPID），我们旨在总结当前CD背景下SBCE内镜评分系统的一般原则和临床应用，涵盖疑似CD的主题以及疾病范围评估（具有潜在的预后和治疗影响）、治疗反应的黏膜愈合评估以及先前确诊为CD的患者术后复发评估。
