Endoskopie bei CED

W. Petritsch; W. Tillinger; H. Vogelsang; W. Reinisch; P. Knoflach; H. Tilg

doi:10.1055/s-2006-927134

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2006; 44(11): 1183-1192
DOI: 10.1055/s-2006-927134

Mitteilungen

Endoskopie bei CED

Konsensuskonferenz der Arbeitsgruppe für CED innerhalb der ÖGGHEndoscopy in IBDA Consensus Report of the IBD Working Group of the Austrian Association of Gastroenterology and HepatologyW. Petritsch¹ , W. Tillinger² , H. Vogelsang³ , W. Reinisch³ , P. Knoflach⁴ , H. Tilg⁵

¹Universitätsklinik für Innere Medizin, Klinische Abteilung für Gastroenterologie und Hepatologie, Medizinische Universität Graz
²Krankenhaus Hietzing, 1. Medizinische Abteilung, Wien
³AKH Wien, Innere Medizin IV, Medizinische Universität Wien
⁴Interne Abteilung I, KH der Barmherzigen Schwestern, Wels
⁵Interne Abteilung, KH Hall in Tirol

Abstract

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

Full Text

References

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Prof. Dr. Wolfgang Petritsch

Department of (Internal Medicine), Medical University Graz

Auenbruggerplatz 15

8036 Graz, Österreich

Phone: ++43/3 16/3 85 43 86

Fax: ++43/3 16/3 85 43 87

Email: wolfgang.petritsch@meduni-graz.at