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胶囊内镜与小肠镜在乳糜泻中的应用。

Capsule Endoscopy and Enteroscopy in Celiac Disease.

机构信息

Division of Digestive Diseases, Celiac Disease Center at Columbia University, Columbia University, 180 Fort Washington Avenue, New York, NY 10032, USA.

The University of Chicago, 5841 South Maryland Avenue, MC 4080 S401, Chicago, IL 60637, USA.

出版信息

Gastroenterol Clin North Am. 2019 Mar;48(1):73-84. doi: 10.1016/j.gtc.2018.09.005. Epub 2018 Dec 14.

Abstract

Celiac disease predominantly involves the proximal small bowel, but villus atrophy can be patchy, spare the duodenum, and be present more distally. Video capsule endoscopy is more sensitive than standard endoscopy to detect villus atrophy, and can define extent of disease, though it cannot obtain biopsies. Duodenal biopsy is the gold standard for diagnosis. Video capsule endoscopy assists in special circumstances when biopsy is not possible, and in equivocal diagnosis. Video capsule endoscopy and enteroscopy are recommended for evaluating complicated celiac disease, especially refractory celiac disease type II. Future developments include computer-assisted capsule programs and advanced capsule and enteroscope design.

摘要

乳糜泻主要累及近端小肠,但绒毛萎缩可能呈斑片状,不累及十二指肠,并可更远处出现。视频胶囊内镜比标准内镜更能检测到绒毛萎缩,并且可以定义疾病的范围,尽管它不能获得活检。十二指肠活检是诊断的金标准。在无法进行活检的特殊情况下,以及在诊断不明确时,视频胶囊内镜可协助诊断。推荐对复杂乳糜泻,特别是难治性乳糜泻Ⅱ型,使用视频胶囊内镜和小肠镜进行评估。未来的发展包括计算机辅助胶囊程序和先进的胶囊和小肠镜设计。

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