THE EXPERIENCE OF MODERN METHODS OF ENTEROSCOPY IN THE DIAGNOSIS OF CROHN’S DISEASE
The aim of the study is to evaluate the possibilities of videocapsule endoscopy (VCE), single and double balloon enteroscopy in diagnosis of small bowel Crohn’s disease. Material and methods. From V.2003 to IV.2011 we observed 52 pts. with suspected small bowel Crohn’s disease; 8 (15,4%) of them were operated urgently because of complications. Another 44 pts (m-23, f-21, ranged from 15-72 years, mean age 37.5 ± 12.0 years) underwent complex examination including 19 VCE and 49 BAE in 32 pts.(incl. 7 after VCE). Results. Typical Crohn’s disease appearance was found in 15 (34.1%) pts (incl. 4pts after VCE) from 44 who were examined endoscopically. In 8 pts we`ve revealed stenosis, in 4 of them we`ve passed through the ileocecal valve stenosis by bouginage with the enteroscope and were able to examine superior area. After performing target biopsy from the small bowel mucosal lesions Pirogov - Langhans cells were found in 5 (33.3%) pts. We haven`t found any signs of Crohn`s disease in 17 pts. (no abnormalities found-6, enteritis-9, celiac disease-1, NSAID-ulcers-1). Conservative treatment has been applied in 10 (66.7%) pts., surgical intervention - in 5 (33.3%) pts. There was a capsule retention in 2 (10.5%) pts. There were no any complications in BAE. The use of the new enteroscopic techniques substantially improves the diagnosis of small bowel Crohn’s disease and allows to determine a proper treatment for the patients