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Systematic Review and Meta-analysis
- Stricturing Crohn's disease: what is the role of endoscopic stenting? A systematic review
- Giorgia Burrelli Scotti, Roberto Lorenzetti, Annalisa Aratari, Antonietta Lamazza, Enrico Fiori, Claudio Papi, Stefano Festa
- Clin Endosc 2023;56(6):726-734. Published online October 24, 2023
- DOI: https://doi.org/10.5946/ce.2023.059
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Abstract
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ePub - Background
/Aims: Endoscopic stenting for stricturing Crohn's disease (CD) is an emerging treatment that achieves more persistent dilatation of the stricture over time than endoscopic balloon dilatation (EBD). We aimed to explore the efficacy and safety of stenting for the treatment of CD strictures.
Methods
A systematic electronic literature search was performed (PROSPERO; no. CRD42022308033). The primary outcomes were technical success, efficacy, complication rate, and the need for further interventions due to reobstruction. The outcomes of partially covered self-expanding metal stents (PCSEMS) with scheduled retrieval after seven days were also analyzed.
Results
Eleven eligible studies were included in the review. Overall, 173 patients with CD were included in this study. Mean percentage of technical success was 95% (range, 80%–100%), short-term efficacy was 100% in all studies, and long-term efficacy was 56% (range, 25%–90%). In patients with a scheduled PCSEMS retrieval, the long-term efficacy was 76% (range, 59%–90%), the mean complication rate was 35% (range, 15%–57%), and the major complication rate was 11% (range, 0%–29%).
Conclusions
Endoscopic stenting with scheduled PCSEMS retrieval may be considered a feasible second-line treatment for short CD strictures to postpone surgery. However, larger head-to-head prospective studies are needed to understand the role of stenting as an alternative or additional treatment to EBD in CD. -
Citations
Citations to this article as recorded by
- Perioperative Considerations for the Surgical Treatment of Crohn’s Disease with Discussion on Surgical Antibiotics Practices and Impact on the Gut Microbiome
Shelbi Olson, Lindsay Welton, Cyrus Jahansouz
Antibiotics.2024; 13(4): 317. CrossRef
- Perioperative Considerations for the Surgical Treatment of Crohn’s Disease with Discussion on Surgical Antibiotics Practices and Impact on the Gut Microbiome
- 3,700 View
- 194 Download
- 1 Web of Science
- 1 Crossref
Reviews
- Recent advances in surveillance colonoscopy for dysplasia in inflammatory bowel disease
- Soo-Young Na, Won Moon
- Clin Endosc 2022;55(6):726-735. Published online November 18, 2022
- DOI: https://doi.org/10.5946/ce.2022.132
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Abstract
PDFPubReaderePub
- Inflammatory bowel disease (IBD) has a global presence with rapidly increasing incidence and prevalence. Patients with IBD including those with ulcerative colitis and Crohn’s disease have a higher risk of developing colorectal cancer (CRC) compared to the general population. Risk factors for CRC in patients with IBD include long disease duration, extensive colitis, primary sclerosing cholangitis, family history of CRC, stricture, and prior dysplasia. Surveillance colonoscopy for CRC in patients with IBD should be tailored to individualized risk factors and requires careful monitoring every year to every five years. The current surveillance techniques are based on several guidelines. Chromoendoscopy with targeted biopsy is being recommended increasingly, and high-definition colonoscopy is gradually replacing standard-definition colonoscopy. However, it remains unclear whether chromoendoscopy, virtual chromoendoscopy, or white-light endoscopy has better efficiency when a high-definition scope is used. With the development of new endoscopic instruments and techniques, the paradigm of surveillance strategy has gradually changed. In this review, we discuss cutting-edge surveillance colonoscopy in patients with IBD including a review of literature.
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Citations
Citations to this article as recorded by- Inflammatory bowel disease and primary sclerosing cholangitis: One disease or two?
Kim N. van Munster, Annika Bergquist, Cyriel Y. Ponsioen
Journal of Hepatology.2024; 80(1): 155. CrossRef - Extrachromosomal Circular DNA: An Emerging Potential Biomarker for Inflammatory Bowel Diseases?
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Genes.2024; 15(4): 414. CrossRef - Advancing Colorectal Cancer Prevention in Inflammatory Bowel Disease (IBD): Challenges and Innovations in Endoscopic Surveillance
Ernesto Fasulo, Ferdinando D’Amico, Alessandra Zilli, Federica Furfaro, Clelia Cicerone, Tommaso Lorenzo Parigi, Laurent Peyrin-Biroulet, Silvio Danese, Mariangela Allocca
Cancers.2024; 17(1): 60. CrossRef - A Review of Colonoscopy in Intestinal Diseases
Seung Hong, Dong Baek
Diagnostics.2023; 13(7): 1262. CrossRef - Potential Oral Microbial Markers for Differential Diagnosis of Crohn’s Disease and Ulcerative Colitis Using Machine Learning Models
Sang-Bum Kang, Hyeonwoo Kim, Sangsoo Kim, Jiwon Kim, Soo-Kyung Park, Chil-Woo Lee, Kyeong Ok Kim, Geom-Seog Seo, Min Suk Kim, Jae Myung Cha, Ja Seol Koo, Dong-Il Park
Microorganisms.2023; 11(7): 1665. CrossRef - Update on Endoscopic Dysplasia Surveillance in Inflammatory Bowel Disease
Nayantara Coelho-Prabhu, James D. Lewis
American Journal of Gastroenterology.2023; 118(10): 1748. CrossRef
- Inflammatory bowel disease and primary sclerosing cholangitis: One disease or two?
- 4,495 View
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- 6 Web of Science
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- Chronological Review of Endoscopic Indices in Inflammatory Bowel Disease
- Joon Seop Lee, Eun Soo Kim, Won Moon
- Clin Endosc 2019;52(2):129-136. Published online August 21, 2018
- DOI: https://doi.org/10.5946/ce.2018.042
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Abstract
PDFPubReaderePub
- Inflammatory bowel disease (IBD) is considered a chronic condition characterized by mucosal or transmural inflammation in the gastrointestinal tract. Endoscopic diagnosis and surveillance in patients with IBD have become crucial. In addition, endoscopy is a useful modality in estimation and evaluation of the disease, treatment results, and efficacy of treatment delivery and surveillance. In relation to these aspects, endoscopic disease activity has been commonly estimated in clinical practices and trials.
At present, many endoscopic indices of ulcerative colitis have been introduced, including the Truelove and Witts Endoscopy Index, Baron Index, Powell-Tuck Index, Sutherland Index, Mayo Clinic Endoscopic Sub-Score, Rachmilewitz Index, Modified Baron Index, Endoscopic Activity Index, Ulcerative Colitis Endoscopic Index of Severity, Ulcerative Colitis Colonoscopic Index of Severity, and Modified Mayo Endoscopic Score. Endoscopic indices have been also suggested for Crohn’s disease, such as the Crohn’s Disease Endoscopic Index of Severity, Simple Endoscopic Score for Crohn’s Disease, and Rutgeerts Postoperative Endoscopic Index. However, most endoscopic indices have not been validated owing to the complexity of their parameters and inter-observer variations. Therefore, a chronological approach for understanding the various endoscopic indices relating to IBD is needed to improve the management. -
Citations
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Frontiers in Gastroenterology.2024;[Epub] CrossRef - Disease clearance in ulcerative colitis: Setting the therapeutic goals for future in the treatment of ulcerative colitis
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GastroHep.2022; 2022: 1. CrossRef - Assessment of Endoscopic Disease Activity in Ulcerative Colitis: Is Simplicity the Ultimate Sophistication?
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- Self‐assessment with pediatric inflammatory bowel disease endoscopy scoring tools: A quality improvement pilot study
- 13,061 View
- 498 Download
- 16 Web of Science
- 22 Crossref
- Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease
- Ji Min Lee, Kang-Moon Lee
- Clin Endosc 2016;49(4):370-375. Published online July 29, 2016
- DOI: https://doi.org/10.5946/ce.2016.090
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Abstract
PDFPubReaderePub
- Patients with inflammatory bowel disease have significantly increased in recent decades in Korea. Intestinal tuberculosis (ITB) and intestinal Behcet’s disease (BD), which should be differentiated from Crohn’s disease (CD), are more frequent in Korea than in the West. Thus, the accurate diagnosis of these inflammatory diseases is problematic in Korea and clinicians should fully understand their clinical and endoscopic characteristics. Ulcerative colitis mostly presents with rectal inflammation and continuous lesions, while CD presents with discontinuous inflammatory lesions and frequently involves the ileocecal area. Involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps are more frequently seen in ITB than in CD. A few ulcers with discrete margins are a typical endoscopic finding of intestinal BD. However, the differential diagnosis is difficult in many clinical situations because typical endoscopic findings are not always observed. Therefore, clinicians should also consider symptoms and laboratory, pathological, and radiological findings, in addition to endoscopic findings.
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Citations
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- 894 Download
- 38 Web of Science
- 40 Crossref
- Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives
- Hyun Ho Choi, Young-Seok Cho
- Clin Endosc 2016;49(3):257-265. Published online March 9, 2016
- DOI: https://doi.org/10.5946/ce.2015.117
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Abstract
PDFPubReaderePub
- Fecal microbiota transplantation (FMT) is the infusion of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease. A fecal suspension can be administered by nasogastric or nasoduodenal tube, colonoscope, enema, or capsule. The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson’s disease, fibromyalgia, chronic fatigue syndrome, myoclonus dystopia, multiple sclerosis, obesity, insulin resistance, metabolic syndrome, and autism. There are many unanswered questions regarding FMT, including donor selection and screening, standardized protocols, long-term safety, and regulatory issues. This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT.
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Postgraduate Medical Journal.2024; 100(1186): 539. CrossRef - Complementary Therapeutic Effect of Fecal Microbiota Transplantation in Ulcerative Colitis after the Response to Anti-Tumor Necrosis Factor Alpha Agent Was Lost: A Case Report
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International Journal of Molecular Sciences.2023; 24(3): 1849. CrossRef - Gut Microbiota and Alzheimer’s Disease: How to Study and Apply Their Relationship
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Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef - Fecal microbiota transplantation for the treatment of irritable bowel syndrome: A systematic review and meta-analysis
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Frontiers in Immunology.2022;[Epub] CrossRef - Role of Intestinal Dysbiosis and Nutrition in Rheumatoid Arthritis
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Case Report
- Tracheal Involvement in Crohn Disease: the First Case in Korea
- Seunghyun Park, Jongha Park, Hyun-Kuk Kim, Ji Yeon Kim, So Chong Hur, Ju Hyung Lee, Jae Won Jung, Juwon Lee
- Clin Endosc 2016;49(2):202-206. Published online February 16, 2016
- DOI: https://doi.org/10.5946/ce.2015.059
- Correction in: Clin Endosc 2016;49(3):310
-
Abstract
PDFPubReaderePub
- Respiratory involvement in Crohn disease (CD) is rare condition with only about a dozen reported cases. We report the first case of CD with tracheal involvement in Korea. An 18-year-old woman with CD was hospitalized because of coughing, dyspnea, and fever sustained for 3 weeks. Because she had stridor in her neck, we performed computed tomography of the neck, which showed circumferential wall thickening of the larynx and hypopharynx. Bronchoscopy revealed mucosal irregularity, ulceration, and exudates debris in the proximal trachea, and bronchial biopsy revealed chronic inflammation with granulation tissue. Based on these findings, we suspected CD with tracheal involvement and began administering intravenous methylprednisolone at 1 mg/kg per day, after which her symptoms and bronchoscopic findings improved.
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Citations
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Focused Review Series: A Perspective: Endoscopy and Imagings in Inflammatory Bowel Disease
- Computed Tomography Enterography for Evaluation of Inflammatory Bowel Disease
- Min Jung Park, Joon Seok Lim
- Clin Endosc 2013;46(4):327-366. Published online July 31, 2013
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-
Abstract
PDFPubReaderePub
Computed tomography enterography (CTE) has become a main modality for the evaluation of inflammatory bowel disease (IBD). It simultaneously offers visualization of the small bowel and extraintestinal status, which is helpful for diagnosing IBD. Crohn disease has long segmental enhancing wall thickening related with the eccentric longitudinal distribution. In addition, mural stratification, fibrofatty proliferation, positive comb sign by increased mesenteric vascularity and internal/perianal fistula are characteristics of Crohn disease and can be identified on CTE. Short segmental inflammatory wall thickening and the central low attenuated lymph nodes are favorable CT finding of intestinal tuberculosis. A geographic, relatively large, and deep penetrating ulcer with bowel wall thickening and mural hyperenhancement in ileocecal area are characteristics of intestinal Behcet disease. Each of CTE findings for the IBDs is helpful for differential diagnosis. The main disadvantage of this technique is the requisite radiation exposure of patients, particularly in young patients. However, recent development of advanced CT techniques is promising for radiation dose reduction without compromising diagnostic image quality.
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Citations
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- Small Bowel Endoscopy in Inflammatory Bowel Disease
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- Clin Endosc 2013;46(4):321-326. Published online July 31, 2013
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Abstract
PDFPubReaderePub
Crohn disease (CD) is a chronic inflammatory bowel disease that affects the entire gastrointestinal tract but is most frequently localized to the large and small bowel. Small bowel endoscopy helps with the differential diagnosis of CD in suspected CD patients. Early diagnosis of CD is preferable for suspected CD conditions to improve chronic inflammatory infiltrates, fibrosis. Small bowel endoscopy can help with the early detection of active disease, thus leading to early therapy before the onset of clinical symptoms of established CD. Some patients with CD have mucosal inflammatory changes not in the terminal ileum but in the proximal small bowel. Conventional ileocolonoscopy cannot detect ileal involvement proximal to the terminal ileum. Small bowel endoscopy, however, can be useful for evaluating these small bowel involvements in patients with CD. Small bowel endoscopy by endoscopic balloon dilation (EBD) enables the treatment of small bowel strictures in patients with CD. However, many practical issues still need to be addressed, such as endoscopic findings for early detection of CD, application compared with other imaging modalities, determination of the appropriate interval for endoscopic surveillance of small bowel lesions in patients with CD, and long-term prognosis after EBD.
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Abstract
PDFPubReaderePub
An endoscopic evaluation, particularly ileocolic mucosal and histological findings, is essential for the diagnosis of inflammatory bowel disease (IBD). The introduction of antitumor necrosis factor agents has changed the therapeutic paradigm of patients with IBD, but an endoscopic evaluation is more important to guide therapeutic decision-making. In the future, endoscopy with a histological evaluation will be increasingly used in patients with IBD. Both Crohn colitis and ulcerative colitis result in an increased incidence of colorectal carcinoma. Thus, surveillance colonoscopy is important to detect early neoplastic lesions. Surveillance ileocolonoscopy has also changed recently from multiple random biopsies to pancolonic dye spraying with targeted biopsies of abnormal areas.
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Abstract
PDFPubReaderePub
Colonoscopy based colitis surveillance is widely accepted to try to prevent development of and ensure early detection of colitis-associated colorectal cancer. Traditionally this has been performed with quadrantic random biopsies throughout the colon. Chromoendoscopy "dye-spray" with targeted biopsies only has been shown to increase dysplasia detection 4 to 5 fold on a per lesion basis. It has therefore been suggested that random biopsies should be abandoned as they do not increase dysplasia detection nor change patient clinical course. Recent British guidelines for colitis surveillance have strongly endorsed chromoendoscopy. This short review summarizes current international guidelines and looks at how to optimize white light colonoscopy in colitis considering: bowel preparation, withdrawal time, high definition, and structure enhancement. Data for advanced imaging techniques are reviewed including positive evidence in favor of chromoendoscopy, and limited data suggesting autofluoresence imaging may be promising. Narrow band imaging does not increase dysplasia detection in colitis. Confocal endomicroscopy might potentially reduce biopsies beyond that of chromoendoscopy but does not offer a clear detection advantage. Pan-colonic chromoendoscopy with targeted biopsies increases dysplasia detection and is the standard of care in the United Kingdom. It is likely that the use of chromoendoscopy for colitis surveillance will become widely accepted internationally.
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World Journal of Gastroenterology.2014; 20(47): 17709. CrossRef - Colorectal cancer in inflammatory bowel disease: The risk, pathogenesis, prevention and diagnosis
Eun Ran Kim
World Journal of Gastroenterology.2014; 20(29): 9872. CrossRef - Highlights of the 48th Seminar of Korean Society of Gastrointestinal Endoscopy
Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm
Clinical Endoscopy.2013; 46(3): 203. CrossRef
- Colon Cancer
- 7,216 View
- 43 Download
- 21 Crossref
- Role of Computed Tomography Enterography/Magnetic Resonance Enterography: Is It in Prime Time?
- Ah Young Kim
- Clin Endosc 2012;45(3):269-273. Published online August 22, 2012
- DOI: https://doi.org/10.5946/ce.2012.45.3.269
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Abstract
PDFPubReaderePub
Today, cross-sectional imaging modalities, such as computed tomography enterography (CTE) and magnetic resonance enterography (MRE), are particularly suited to evaluate small bowel diseases, especially Crohn's disease (CD). It is well known that CTE/MRE can provide excellent assessment of disease activity as well as the macroscopic features, extramural abnormalities, and complications of the small intestine in patients with CD. In general, CTE is considered as the first-line modality for the evaluation of suspected inflammatory bowel disease and for long-term assessment or follow-up of these patients. Because of the advantage of lack of radiation, MRE is being used more frequently, especially in children or young patients with CD.
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Citations
Citations to this article as recorded by- Indian guidelines on imaging of the small intestine in Crohn’s disease: A joint Indian Society of Gastroenterology and Indian Radiology and Imaging Association consensus statement
Saurabh Kedia, Raju Sharma, Govind Makharia, Vineet Ahuja, Devendra Desai, Devasenathipathy Kandasamy, Anu Eapen, Karthik Ganesan, Uday C Ghosha, Naveen Kalra, R Karthikeyan, Kumble Seetharama Madhusudhan, Mathew Philip, Amarender Puri, Sunil Puri, Saroj
Indian Journal of Radiology and Imaging.2019; 29(02): 111. CrossRef - Imaging in discriminating intestinal tuberculosis and Crohn’s disease: past, present and the future
Pradeep Goyal, Jimil Shah, Sonali Gupta, Pankaj Gupta, Vishal Sharma
Expert Review of Gastroenterology & Hepatology.2019; 13(10): 995. CrossRef - The effect of without using anisodamine during CT enterography on image quality, diagnostic performance and latent side effects
Didi Wen, Jian Xu, Ying Liu, Rui An, Jian Li, Hongliang Zhao, Minwen Zheng
Clinical Imaging.2018; 48: 106. CrossRef - Ileal Crohn's disease activity predicted by ruler: CT enterography histopathology correlation
Tamer W. Kassem
The Egyptian Journal of Radiology and Nuclear Medicine.2017; 48(1): 7. CrossRef - Faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease: a prospective study
Takahiro Shimoyama, Takayuki Yamamoto, Satoru Umegae, Koichi Matsumoto
Therapeutic Advances in Gastroenterology.2017; 10(8): 577. CrossRef - Imaging of the small intestine in Crohn’s disease: Joint position statement of the Indian Society of Gastroenterology and Indian Radiological and Imaging Association
Saurabh Kedia, Raju Sharma, Govind K. Makharia, Vineet Ahuja, Devendra Desai, Devasenathipathy Kandasamy, Anu Eapen, Karthik Ganesan, Uday C. Ghoshal, Naveen Kalra, D. Karthikeyan, Kumble Seetharama Madhusudhan, Mathew Philip, Amarender Singh Puri, Sunil
Indian Journal of Gastroenterology.2017; 36(6): 487. CrossRef - Diagnosis of Small-Bowel Diseases: Prospective Comparison of Multi–Detector Row CT Enterography with MR Enterography
Gabriele Masselli, Marco Di Tola, Emanuele Casciani, Elisabetta Polettini, Francesca Laghi, Riccardo Monti, Maria Giulia Bernieri, Gianfranco Gualdi
Radiology.2016; 279(2): 420. CrossRef - Value of Computerized Tomography Enterography in Predicting Crohn’s Disease Activity: Correlation with Crohn’s Disease Activity Index and C-Reactive Protein
Eun Kyung Park, Na Yeon Han, Beom Jin Park, Deuk Jae Sung, Sung Beom Cho, Yoon Tae Jeen, Bora Keum, Min Ju Kim
Iranian Journal of Radiology.2016;[Epub] CrossRef - Identifying the inflammatory and fibrotic bowel stricture: MRI diffusion-weighted imaging in Crohn's disease
Jianguo Zhu, Faming Zhang, Fei Liu, Wenwen He, Jun Tian, Huiyun Han, Peng Cao
Radiology of Infectious Diseases.2015; 2(3): 128. CrossRef - Imaging Inflammatory Bowel Disease with CT and MR Enterography
Piotr Starakiewicz, David J. Grand
Current Radiology Reports.2013; 1(4): 277. CrossRef
- Indian guidelines on imaging of the small intestine in Crohn’s disease: A joint Indian Society of Gastroenterology and Indian Radiology and Imaging Association consensus statement
- 7,057 View
- 74 Download
- 10 Crossref
- A Look into the Small Bowel in Crohn's Disease
- Soo Jung Park, Won Ho Kim
- Clin Endosc 2012;45(3):263-268. Published online August 22, 2012
- DOI: https://doi.org/10.5946/ce.2012.45.3.263
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Abstract
PDFPubReaderePub
Crohn's disease (CD) is an inflammatory bowel disease that can affect the entire gastrointestinal tract, with the small bowel (SB) being the most commonly affected site. In some patients, refractory inflammation or chronic strictures of the SB are responsible for a debilitating course of the disease that might lead to severely reduced quality of life. Therefore, SB imaging is a crucial element in diagnosing and/or managing SB CD, and continues to evolve because of technologic advances. SB endoscopy (capsule endoscopy and device-assisted enteroscopy) and cross-sectional radiologic imaging (computed tomography enterography and magnetic resonance enterography) have become key players to diagnose and/or manage CD. In everyday practice, the choice of the imaging modalities is based on the presence and availability of the techniques and of experienced operators in each institute, clinical usefulness, safety, and cost. Here, SB endoscopy and radiologic imaging in suspected or known CD patients will be addressed and discussed.
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Citations
Citations to this article as recorded by- ECHOGRAPHY IN THE DIAGNOSTICS OF INFLAMMATORY BOWEL DISEASES IN CHILDREN
M. I. Pykov, A. M. Vrublevskaya
Russian Journal of Pediatric Surgery.2020; 24(2): 101. CrossRef - Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease
Benjamin Tharian, Nayana George, Udayakumar Navaneethan
Inflammatory Bowel Diseases.2016; 22(5): 1184. CrossRef - The role of capsule endoscopy in evaluating both suspected and known Crohnʼs disease
Erika S. Boroff, Jonathan A. Leighton
Techniques in Gastrointestinal Endoscopy.2015; 17(1): 5. CrossRef
- ECHOGRAPHY IN THE DIAGNOSTICS OF INFLAMMATORY BOWEL DISEASES IN CHILDREN
- 7,566 View
- 70 Download
- 3 Crossref
- Retrieval of a Retained Capsule due to Isolated Crohn's Enteritis by Means of Double Balloon Enteroscopy
- Kon-Ho Shim, M.D., Soo-Yeon Jung, M.D., Jun-Ho Song, M.D., Hyeug Lee, M.D., Eui-Hyung Kim, M.D., Eun-Jung Jeon, M.D., Jung-Hwan Oh, M.D., Jeong-Jo Jeong, M.D., Hwang Choi, M.D. and Sang-Wook Choi, M.D.
- Korean J Gastrointest Endosc 2007;35(6):399-403. Published online December 30, 2007
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Abstract
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- Capsule endoscopy is being increasingly used for investigating GI bleeding of an obscure origin and also the bleeding that's due to Crohn's disease. Capsule endoscopy is a safe procedure with few complications. Complications of capsule endoscopy are capsule retention, incomplete small bowel examination, swallowing disorders and technical complications. However, capsule retention still remains a major concern. Crohn's disease may rarely show its first manifestation as GI bleeding. We present here a case of obscure GI bleeding in which the diagnosis of isolated Crohn's enteritis was made by using wireless CE. The retained capsule at the jejunal stricture of Crohn's disease was successfully retrieved by performing double balloon enteroscopy. (Korean J Gastrointest Endosc 2007;35:399-403)
- 2,415 View
- 6 Download
- Clinical Features and Course of Crohn Disease in Children
- Na Young Lee, M.D. and Jae Hong Park, M.D.*
- Korean J Gastrointest Endosc 2007;34(4):193-199. Published online April 30, 2007
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Abstract
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- Background
/Aims: The aim of this study was to evaluate the clinical features and course of Crohn disease (CD) in children. Methods: The medical records of 30 patients diagnosed with CD between January 1996 and December 2005 were reviewed retrospectively. Results: The actual number of newly diagnosed patients with CD has increased during the 8-year period. The male/female ratio was 2：1 and the mean age at diagnosis was 10.6⁑4.3 years. The major symptoms of CD at diagnosis were abdominal pain (79.2%), weight loss (54.2%), perianal lesion (54.2%), diarrhea (45.8%), hematochezia (41.7%), anemia (29.2%), and fever (23.3%). The disease location of CD was the small bowel in 33.3%, the large bowel in 12.5% and both the small and large bowel in 54.2%. Granuloma was found in 54.2% of patients. The relapse rate of CD in the group with a higher pediatric Crohn disease activity index (PCDAI) at diagnosis (≥30) was higher than in the group with a lower PCDAI (＜30). The cumulative relapse rates of the patients with granuloma were 30.2% within 1 year and 53.8% within 5 years after the diagnosis. Conclusions: The incidence of CD in children appears to be increasing. Granuloma formation and a higher score of the PCDAI are associated with a more severe disease course. Pediatric CD may have a somewhat different clinical presentation from older-onset CD. (Korean J Gastrointest Endosc 2007;34:193199)
- 2,364 View
- 26 Download
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