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无症状性末端回肠炎的管理

Management of Asymptomatic Terminal Ileitis.

作者信息

Donet Jean A, Charabaty Aline, Moss Alan C

机构信息

Division of Gastroenterology, University of California San Francisco-Fresno, Fresno, California, USA.

Division of Gastroenterology, Johns Hopkins School of Medicine, Sibley Memorial Hospital, Washington, District of Columbia, USA.

出版信息

Crohns Colitis 360. 2020 Oct 12;2(4):otaa065. doi: 10.1093/crocol/otaa065. eCollection 2020 Oct.

DOI:10.1093/crocol/otaa065
PMID:36777745
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9802103/
Abstract

Ileal intubation is often performed during screening colonoscopies. This had led to the recognition of mild ileitis in many asymptomatic patients. The natural history and clinical significance of this finding are not well established, and there are no guidelines on whether these patients merit further work-up or an interval surveillance colonoscopy. This conundrum was presented and discussed on @MondayNightIBD. In this article, we review the specific literature on the topic and make reference to the informed opinions of the convo participants. We propose an #IBDAlgorithm for management of asymptomatic ileitis.

摘要

在结肠镜筛查期间经常进行回肠插管。这使得许多无症状患者被诊断出患有轻度回肠炎。这一发现的自然病程和临床意义尚未明确,对于这些患者是否需要进一步检查或进行定期结肠镜监测也没有相关指南。这个难题在@MondayNightIBD上被提出并讨论。在本文中,我们回顾了关于该主题的具体文献,并参考了讨论参与者的专业意见。我们提出了一种用于无症状回肠炎管理的#IBD算法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/048f/9802103/3071425328b0/otaa065_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/048f/9802103/3071425328b0/otaa065_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/048f/9802103/3071425328b0/otaa065_fig1.jpg

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本文引用的文献

1
Normalization of Fecal Calprotectin Within 12 Months of Diagnosis Is Associated With Reduced Risk of Disease Progression in Patients With Crohn's Disease.在诊断后的 12 个月内,粪便钙卫蛋白正常化与克罗恩病患者疾病进展风险降低相关。
Clin Gastroenterol Hepatol. 2021 Sep;19(9):1835-1844.e6. doi: 10.1016/j.cgh.2020.08.022. Epub 2020 Aug 13.
2
Current knowledge on non-steroidal anti-inflammatory drug-induced small-bowel damage: a comprehensive review.非甾体抗炎药诱导的小肠损伤的现有知识:全面综述。
J Gastroenterol. 2020 May;55(5):481-495. doi: 10.1007/s00535-019-01657-8. Epub 2019 Dec 21.
3
Aspecific ileitis: Crohn's disease or not Crohn's disease? A prospective study.
年轻的胃肠角#推特转论文:将推特上的一个想法转化为论文。
United European Gastroenterol J. 2021 Feb;9(1):129-132. doi: 10.1002/ueg2.12053. Epub 2021 Mar 1.
特异性回肠炎:是克罗恩病还是非克罗恩病?一项前瞻性研究。
Int J Colorectal Dis. 2017 Jul;32(7):1025-1028. doi: 10.1007/s00384-017-2770-3. Epub 2017 Feb 4.
4
Silent Crohn's Disease Predicts Increased Bowel Damage During Multiyear Follow-up: The Consequences of Under-reporting Active Inflammation.无症状克罗恩病在多年随访中预示肠道损伤增加:漏报活动性炎症的后果
Inflamm Bowel Dis. 2016 Nov;22(11):2665-2671. doi: 10.1097/MIB.0000000000000935.
5
Silent Crohn's Disease: Asymptomatic Patients with Elevated C-reactive Protein Are at Risk for Subsequent Hospitalization.无症状克罗恩病:C反应蛋白升高的无症状患者有后续住院风险。
Inflamm Bowel Dis. 2015 Oct;21(10):2254-61. doi: 10.1097/MIB.0000000000000516.
6
Terminal ileitis is not always Crohn's disease.末端回肠炎并非总是克罗恩病。
Ann Gastroenterol. 2011;24(4):271-275.
7
Isolated terminal ileal ulcer in asymptomatic patients: a call for prospective studies with long-term follow-up to determine the need for surveillance colonoscopy.
Gastrointest Endosc. 2011 Jun;73(6):1331-2. doi: 10.1016/j.gie.2010.12.021.
8
Isolated terminal ileal ulcerations in asymptomatic individuals: natural course and clinical significance.无症状个体孤立性末端回肠溃疡:自然病程和临床意义。
Gastrointest Endosc. 2010 Dec;72(6):1226-32. doi: 10.1016/j.gie.2010.08.029.
9
Isolated asymptomatic ileitis does not progress to overt Crohn disease on long-term follow-up despite features of chronicity in ileal biopsies.尽管回肠活检显示有慢性特征,但孤立性无症状回肠炎在长期随访中不会进展为明显的克罗恩病。
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10
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Scand J Gastroenterol. 2008 Aug;43(8):948-54. doi: 10.1080/00365520801957149.