| Theme | Now is the time for the "Intestine" -- updates and problems raised to be solved in IBD | |
|---|---|---|
| Title | Color image of inflammatory bowel disease usjag double balloon endoscopy | |
| Publish Date | 2009/01 | |
| Author | Keijiro Sunada | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Naoyuki Nishimura | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Hiromi Fukushima | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Yoshikazu Hayashi | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Masayuki Arashiro | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Tomonori Yano | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Tomohiko Miyata | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Hironori Yamamoto | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| [ Summary ] | Recently developed capsule endoscopy (CE) and double balloon endoscopy (DBE) have enabled direct visualization of the small intestinal lesions. Morphological findings are very important for correct diagnosis of inflammatory diseases of the small intestine. In addition, localization of ulcers on the mesenteric side or the antimesenteric side helps differentiate various diseases. Aphthoid ulcers and discrete ulcer lesions are typical early lesions observed with Crohn's disease. These lesions are observed without surrounding mucosal inflammation, tending to align longitudinally. They progress to longitudinal ulcers that are located mainly on the mesenteric side. The DBE scope is usually inserted deeply into the small intestine forming concentric circles. The mesentery is extended fanlike in these circles. In this situation, the inner side of the concentric circle corresponds to the mesenteric side of the intestinal lumen. These ulcers may finally cause complications, such as strictures, fistula or in some cases, intraabdominal abscess. Mucosal healing (MH), which can be observed directly by using DBE, is now considered to be an important sign of the efficacy of treatment and a prognostic marker for long-term disease. |
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