| Theme |
Intestinal inflammation in small bowel |
| Title |
Efficacy of balloon assisted enteroscopy for diagnosis and treatment of Crohn's disease |
| Author |
Tomoyuki Tsujikawa |
Comprehensive Internal Medicine, Shiga University of Medical Science |
| Author |
Takao Saotome |
Comprehensive Internal Medicine, Shiga University of Medical Science |
| Author |
Akihiko Itoh |
Comprehensive Internal Medicine, Shiga University of Medical Science |
| Author |
Shigeki Sakai |
National Hospital Organization Higashi-Ohmi General Medical Center |
| Author |
Hiroo Mizuta |
National Hospital Organization Higashi-Ohmi General Medical Center |
| Author |
Shigeki Bamba |
Department of Gastroenterology, Shiga University of Medical Science |
| Author |
Akira Andoh |
Department of Gastroenterology, Shiga University of Medical Science |
| [ Summary ] |
Balloon assisted enteroscopy (BAE) is suitable as an initial diagnostic modality for Crohn's disease because retrograde endoscopic procedures, including biopsies with BAE can enable us to observe small intestinal and colonic lesions in one procedure. In addition, indications for BAE increase with the confirmation of mucosal healing after optimal medical treatment. However, careful insertion is necessary in order to avoid mucosal injury and perforations when stenosis and deformation due to ulcers exist. Therefore, if the observation of further deep lesions is necessary, retrograde contrast enterography using enteroscopy may be utilized. For stenosis in the small intestine, which is the most frequent complication observed with Crohn's disease, balloon dilatation with BAE insertion is useful to enable us to avoid surgical intestinal resection. Medial therapy for individual patients is also important to decrease the frequency of repeated dilatations. It is expected that indicatons for capsule endoscopy will increase for the evaluation of mucosal lesions due to Crohn's disease in patients whose small intestines do not exhibit sever stenosis. |