摘要
Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of IBD.Differential diagnosis of CD and UC is important,as theirmedical and surgical treatmentmodalities and prognoses can be different.However,approximately 15%of patients with IBD aremisdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or UC.Recently,there has been increased recognition of the role of the therapeutic endoscopist in the field of IBD.Newer imaging techniques have been developed to aid in the differentiation of UC vs CD.Furthermore,endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentariumof CD stricturemanagement.Endoscopic ultrasound has been recognized as beingmore accurate thanmagnetic resonance imaging in detecting perianal fistulae in patientswith CD.Additionally,chromoendoscopymay help to detect dysplasia earlier compared with white-light colonoscopy.Hence,interventional endoscopy has become a cornerstone in the diagnosis,treatment andmanagement of IBD complications.The role of endoscopy in the field of IBD has significantly evolved in recent years fromsmall-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia surveillance.In this reviewarticle,we discuss the current evidence on interventional endoscopy in the diagnosis,treatment andmanagement of IBD compications.
克罗恩病(CD)和溃疡性结肠炎(UC)是炎症性肠病(IBD)两种最常见的类型。回结肠镜加活检被认为是IBD诊断的金标准。CD与UC的鉴别诊断是非常重要的,因为它们的治疗策略及预后是有所不同的。然而,约有15%的IBD患者由于未能明确诊断为CD或UC而错误地归入了不定型肠炎。内镜在IBD中的作用受到了越来越多的关注。例如,一些新的影像技术有助于CD与UC的内镜下鉴别诊断。内镜球囊扩张和内镜下支架放置已经CD狭窄治疗的重要组成部分。在CD患者的肛瘘检查中,内镜超声也被认为较磁共振更加准确。此外,色素内镜较普通白光肠镜能更早期发现不典型增生。因此,内镜已经成为IBD诊断、治疗以及并发症处理的基石。近年来,内镜在IBD中的作用不断提升,从小肠成像到内镜球囊扩张以及色素内镜对不典型增生的监测。本文我们讨论了内镜用于IBD诊断、治疗和并发症处理的最新证据。
