Isoldi Sara, Mallardo Saverio, Quitadamo Paolo, Leter Beatrice, Cucchiara Salvatore
Pediatric Gastroenterology and Hepatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
Maternal and Child Health Department, Santa Maria Goretti Hospital, Sapienza-University of Rome, Latina, Italy.
Curr Pediatr Rev. 2025;21(2):154-165. doi: 10.2174/0115733963268547231128101929.
Over the past decades, an increased importance has been given to gastrointestinal (GI) endoscopy in the management of children with inflammatory bowel diseases (IBD), considering that mucosal healing has been recognized as the optimal endpoint in the treat-to-target paradigm. The recent advances in technology and anesthesia have facilitated the comprehensive evaluation of the GI tract. In this review, we will discuss the role of ileocolonoscopy, upper GI endoscopy, and device-assisted enteroscopy in the work-up and management of pediatric Crohn's disease (CD) and ulcerative colitis, with particular attention on non-invasive endoscopic techniques, such as wireless capsule endoscopy. We will also analyze the most commonly used endoscopic scoring systems, including small bowel scoring systems and endoscopic recurrence grading of neo-terminal ileum CD. Moreover, we will focus on the endoscopic management of complications, such as strictures, that commonly require surgery. Lastly, we will discuss cancer surveillance in children with IBD, with particular consideration of the role of high-definition endoscopic equipment and chromoendoscopy in dysplasia detection rates.
在过去几十年中，鉴于黏膜愈合已被视为达标治疗模式的最佳终点，胃肠（GI）内镜检查在炎症性肠病（IBD）患儿的管理中变得越来越重要。技术和麻醉方面的最新进展推动了对胃肠道的全面评估。在本综述中，我们将讨论回结肠镜检查、上消化道内镜检查和设备辅助小肠镜检查在小儿克罗恩病（CD）和溃疡性结肠炎的检查及管理中的作用，特别关注非侵入性内镜技术，如无线胶囊内镜检查。我们还将分析最常用的内镜评分系统，包括小肠评分系统和新末端回肠CD的内镜复发分级。此外，我们将重点关注通常需要手术治疗的并发症（如狭窄）的内镜管理。最后，我们将讨论IBD患儿的癌症监测，特别考虑高清内镜设备和色素内镜检查在发育异常检出率方面的作用。
