Endoscopic Diagnosis of Nontumorous Lesions of the Small Intestine Takayuki Matsumoto 1 , Motohiro Esaki 1 , Shotaro Nakamura 1 , Shinichiro Yada 1 , Tomohiko Moriyama 1 , Tetsuji Kudo 1 , Junji Umeno 1 , Shunichi Yanai 1 , Mitsuo Iida 1 1Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Keyword: 小腸内視鏡 , 潰瘍 , 炎症性腸疾患 , 血管異型 , 診断 pp.469-476
Published Date 2008/4/24
DOI https://doi.org/10.11477/mf.1403101319
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 For accurate enteroscopic diagnosis, we classified findings obtained by double balloon endoscopy (DBE) and video-capsule endoscopy (VCE) into ulcers, stenosis, mucosal pattern and vascular lesions. Although DBE and VCE can depict diminutive ulcerous lesions, a subclassification of the small intestinal ulcers into linear, circular and other configurations seems to be appropriate for clinical diagnosis. Even though severe stenoses occur in Crohn's disease, in the case of nonspecific multiple ulcers of the small intestine, nonsteroidal-anti-inflammatory drug-induced ulcers and ischemic enteritis, an assessment of accompanying lesions can lead to a correct diagnosis. Thickened mucosal folds, nodularity, villous swelling and atrophy, and white spots are representative mucosal patterns found in the diseased small intestine. However, a correct diagnosis can not be made by the mucosal findings alone. In contrast, the diagnosis of vascular lesions has been improved dramatically by means of DBE and VCE. Such an improvement in the accuracy of enteroscopy suggests a need for gastroenterologists to establish an algorithm of diagnostic procedures for patients suspected of having small intestinal pathology.

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