Amadu Muniratu, Soldera Jonathan
Department of Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom.
World J Methodol. 2024 Mar 20;14(1):88619. doi: 10.5662/wjm.v14.i1.88619.
Inflammatory bowel disease, including ulcerative colitis, microscopic colitis, and Crohn's disease (CD), has a global impact. This review focuses on duodenal CD (DCD), a rare subtype affecting the duodenum. DCD's rarity and asymptomatic nature create diagnostic challenges, impacting prognosis and patient well-being. Delayed diagnosis can worsen DCD outcomes.
To report a rare case of DCD and to discuss the diagnostic challenges and its implications on prognosis.
A systematic literature search, following the PRISMA statement, was conducted. Relevant studies were identified and analysed using specific Medical Subject Terms (MeSH) from PubMed/MEDLINE, American Journal of Gastroenterology, and the University of South Wales database. Data collection included information from radiology scans, endoscopy procedures, biopsies, and histopathology results.
The review considered 8 case reports and 1 observational study, involving 44 participants diagnosed with DCD, some of whom developed complications due to delayed diagnosis. Various diagnostic methods were employed, as there is no gold standard workup for DCD. Radiology scans [magnetic resonance imaging (MRI), computed tomography (CT), and upper gastrointestinal X-ray], endoscopy procedures (colonoscopy and esophagogastroduodenoscopy), biopsies, and clinical suspicions were utilized.
This review discusses DCD diagnosis challenges and the roles of CT, MRI, and fluoroscopy. It notes their limitations and compares findings with endoscopy and histopathology studies. Further research is needed to improve diagnosis, emphasizing scan interpretation, endoscopy procedures, and biopsies, especially in high-risk patients during routine endoscopy.
炎症性肠病，包括溃疡性结肠炎、显微镜下结肠炎和克罗恩病（CD），具有全球影响。本综述聚焦于十二指肠克罗恩病（DCD），这是一种影响十二指肠的罕见亚型。DCD的罕见性和无症状性质带来了诊断挑战，影响预后和患者福祉。诊断延迟会使DCD的结局恶化。
报告一例罕见的DCD病例，并讨论诊断挑战及其对预后的影响。
按照PRISMA声明进行了系统的文献检索。使用来自PubMed/MEDLINE、《美国胃肠病学杂志》和南威尔士大学数据库的特定医学主题词（MeSH）识别和分析相关研究。数据收集包括来自放射学扫描、内镜检查、活检和组织病理学结果的信息。
该综述纳入了8例病例报告和1项观察性研究，涉及44名被诊断为DCD的参与者，其中一些人由于诊断延迟而出现并发症。由于DCD没有金标准检查方法，因此采用了各种诊断方法。使用了放射学扫描[磁共振成像（MRI）、计算机断层扫描（CT）和上消化道X线检查]、内镜检查（结肠镜检查和食管胃十二指肠镜检查）、活检以及临床怀疑。
本综述讨论了DCD的诊断挑战以及CT、MRI和荧光镜检查的作用。它指出了它们的局限性，并将结果与内镜检查和组织病理学研究进行了比较。需要进一步研究以改善诊断，重点是扫描解读、内镜检查和活检，尤其是在常规内镜检查期间对高危患者。
