Endoskopie bei chronisch entzündlichen Darmerkrankungen

Zusammenfassung

Die Endoskopie ist essenziell in der Diagnostik und Therapie der chronisch entzündlichen Darmerkrankung. Ihr Stellenwert in der Entzündungsüberwachung und Therapieplanung wird wahrscheinlich in den nächsten Jahren noch zunehmen, da die mukosale Heilung sich als Ansprechparameter etabliert. Komplikationen des Morbus Crohn (z. B. Stenosen) und einer langjährigen Kolitis (z. B. intraepitheliale Neoplasien) können häufig endoskopisch erkannt und therapiert werden. Zur Überwachung bei langjähriger Kolitis hat die Chromoendoskopie einen festen Stellenwert, sie ist nach Studienlage der Weißlichtendoskopie überlegen. Sie kann für Hochrisikopatienten durch neue Techniken wie die konfokale Endomikroskopie ergänzt werden. Ob die Überwachung neue Verfahren der hochauflösenden Endoskopie oder der virtuellen Chromoendoskopie der Chromoendoskopie ebenbürtig sind, ist Gegenstand aktueller Studien.

Abstract

Gastrointestinal endoscopy is essential for the diagnosis and management of inflammatory bowel diseases. Its importance in surveillance of inflammation and therapy is expected to increase once mucosal healing is integrated into guiding therapy and response evaluation. Complications of Crohn’s disease (e. g. stenosis) and long lasting colitis (e. g. intraepithelial neoplasia) are amenable to endoscopic detection and therapy. For IBD surveillance, chromoendoscopy is superior to conventional white light endoscopy. In high risk patients, confocal laser endomicroscopy is able to complement chromoendoscopy. Current studies investigate the role of modern high definition endoscopy and virtual chromoendoscopy in comparison to chromoendoscopy.

Schlüsselwörter

chronisch entzündliche Darmerkrankung - Morbus Crohn - Colitis ulcerosa - Endoskopie - Endomikroskopie

Key words

inflammatory bowel disease - Crohn’s disease - ulcerative colitis - endoscopy - endomicroscopy

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