Prince of Wales Clinical School, UNSW Medicine, Gastrointestinal and Liver Unit, Prince of Wales Hospital, Randwick.
AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, RPA Medical Centre, Camperdown, Sydney, New South Wales, Australia.
Curr Opin Gastroenterol. 2019 May;35(3):235-242. doi: 10.1097/MOG.0000000000000531.
Strictures of the small bowel are an underdiagnosed entity with significant morbidity because of obstruction and risk of perforation and penetrating disease.
Recent advances in imaging, enteroscopy, and therapeutic advances particularly in Crohn's disease have enabled gastroenterologists to target and individualize management of small bowel strictures, preventing untimely surgery and complications.
All patients with obstructive symptoms, suspected small bowel disease, and negative panendoscopy should be evaluated for small intestinal strictures with cross-sectional imaging and considered for capsule endoscopy. Furthermore, the role of device-assisted enteroscopy, initially employed as a diagnostic tool, has evolved into triaging and delivering further medical and interventional treatments.
小肠狭窄是一种诊断不足的疾病,其发病率较高,因为其会导致梗阻、穿孔和穿透性疾病的风险。
成像、小肠镜和治疗技术的最新进展,特别是在克罗恩病方面的进展,使胃肠病学家能够针对小肠狭窄进行靶向治疗和个体化管理,从而避免不必要的手术和并发症。
所有有梗阻症状、疑似小肠疾病和全结肠镜检查阴性的患者都应通过横断面成像进行小肠狭窄评估,并考虑进行胶囊内镜检查。此外,设备辅助小肠镜的作用,最初是作为一种诊断工具,已经演变为分诊和提供进一步的药物和介入治疗。