Endoskopie bei CED

Zusammenfassung

Die Ileokoloskopie mit Stufenbiopsien ist die wichtigste Untersuchung bei Verdacht auf eine chronisch entzündliche Darmerkrankung. In ca. 90 % ist eine Differenzierung zwischen einer Colitis ulcerosa und einem M. Crohn bereits zu Beginn möglich. Spezifische standardisierte Befundinhalte erhöhen die Aussagekraft und erlauben eine Vergleichbarkeit der Befunde. Bei bereits gesicherter Diagnose soll eine (Ileo-)Koloskopie nur bei gezielter Fragestellung durchgeführt werden. Eine Ösophagogastroduodenoskopie ist nur bei Beschwerden des oberen Verdauungstraktes indiziert. Die Kapselendoskopie bzw. Push-Enteroskopie ist derzeit nur bestimmten Fragestellungen vorbehalten. Chronisch entzündliche Darmerkrankungen mit ausgedehntem Dickdarmbefall sind mit einem erhöhten Risiko für kolorektale Karzinome assoziiert. Regelmäßige Vorsorge-Koloskopien mit sorgfältiger Biopsieentnahme ermöglichen den Nachweis prämaligner Läsionen und stellen die Grundlage für eine effektive Krebsprophylaxe dar.

Abstract

Ileocolonoscopy including biopsies is the first line investigation in suspected inflammatory bowel disease (IBD). In up to 90 % of the cases ulcerative colitis and Crohn’s disease are differentiated on endoscopic presentation. Standardised reporting of endoscopic results increases the validity and comparability of IBD findings. When there is a firm diagnosis of IBD, colonoscopy should only be performed for specific questions. An upper gastrointestinal endoscopy is only indicated in patients with upper gastrointestinal symptoms. Push and capsule endoscopy should also be limited to specific questions and situations. IBD with extended colitis is associated with an increased risk for colorectal cancer. Endoscopic surveillance with accurate biopsy sampling is a valuable tool for the prevention of colorectal cancer.

Schlüsselwörter

Darm - Colitis ulcerosa - Morbus Crohn - chronisch entzündliche Darmerkrankung

Key words

intestines - ulcerative colitis - Crohn’s disease - chronic inflammatory bowel disease

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