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Endoskopie heute 2013; 26(3): 184-187
DOI: 10.1055/s-0033-1350343
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Update Kapselendoskopie – Einsatz bei chronisch-entzündlichen Darmerkrankungen

Capsule Endoscopy – Update of use in Crohn’s Disease
J. G. Albert
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Publication History

Publication Date:
09 October 2013 (online)

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Zusammenfassung

Die Dünndarmkapselendoskopie ist im Vergleich mit radiologischen Methoden das sensitivere Verfahren im Nachweis von mukosalen Veränderungen des Dünndarms, die auf einen Morbus Crohn hinweisen. Vor allem im Jejunum und Ileum proximal des terminalen Ileums zeigt die Kapselendoskopie eine höhere Nachweisgenauigkeit als die Magnetresonanztomografie (MRT). Der hohe negativ-prädiktive Wert der Untersuchungstechnik qualifiziert sie zu einer exzellenten Methode, eine chronisch-entzündliche Darmerkrankung ggf. auszuschließen. Eine Änderung im therapeutischen Vorgehen wird durch die kapselendoskopische Untersuchung in bis zu 50 % der Fälle beschrieben, bei Kindern kann dies in bis zu 80 % der Fall sein. Auch bei den Kindern sollte natürlich einer Retention der Videokapsel durch Patientenauswahl und ggf. Anwendung der „Patency“-Kapsel vorgebeugt werden. Vorschläge zu Kapselendoskopie-Scores liegen vor, eine umfassende Validierung in prospektiven Patientenkohorten mit Bezug zum klinischen Befinden der Patienten steht noch aus. Die Kolonkapselendoskopie scheint vielversprechend im Einsatz bei chronisch-entzündlichen Darmerkrankungen, der genaue Stellenwert bleibt derzeit noch offen und muss durch zukünftige Studien evaluiert werden.

Abstract

Small bowel capsule endoscopy is more sensitive in detecting small bowel Crohn’s disease in the proximal small bowel than magnetic resonance imaging. It provides a high negative predictive value and thereby offers the capability to exclude chronic inflammatory bowel disease. Clinical management changes in up to 50 % of adult patients in the published series, and up to 80 % of pediatric patients profit from a therapeutic impact of this technique. In children as well as in adults, capsule retention needs consideration, and the patency capsule might reliably prevent video capsule retention. Colon capsule endoscopy is promising in use in chronic-inflammatory bowel disease, but prospective studies are needed to evaluate

Schlüsselwörter

Endoskopie - Kapselendoskopie - Morbus Crohn - Dünndarm - Enteroskopie

Key words

endoscopy - capsule endoscopy - Crohn’s disease - small bowel - enteroscopy
 

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