HOW TO PICK UP EARLY LESIONS OF INFLAMMATORY BOWEL DISEASE

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  • HATADA Yasumasa
    Department of Gastroenterology, Social Insurance Chuo General Hospital.

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  • IBD初期病変の拾い上げのコツ

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Abstract

Aphthoid ulceration has been regarded as an early macroscopic feature of Crohn's disease (CD) and ulcerative colitis (UC). The important endoscopic findings in this condition are (1) redness and/or white coated change of the ulceration, (2) elevation of the area around the aphthae, and (3) the distributions of the aphthae. Indigo carmine dye spraying is useful for the careful observation of such ulcers. The characteristic findings in the case of early lesions in CD are mild elevation with central depression of the affected surface or ulceration and longitudinal distribution of ulcers, but these findings are not unique to inflammatory bowel disease. Histological findings such as non-caseating epithelioid granulomas provide colonoscopists useful information for the diagnosis of CD. When only aphthous lesions are detected, it is necessary to confirm the diagnosis of IBD, especially CD, on the basis of findings in the upper gastrointestinal tract and small intestine and extraintestinal manifestations.

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