БОЛЕЗНЬ КРОНА: ПОРАЖЕНИЕ ПИЩЕВОДА, ЖЕЛУДКА И ДВЕНАДЦАТИПЕРСТНОЙ КИШКИ
Аннотация
Симптомы болезни Крона, проявляющиеся в верхних частях желудочно-кишечного тракта, обычно маскируются под типичные признаки поражения подвздошной и ободочной кишки и встречаются лишь у 0,5–4% взрослых пациентов. Но с усовершенствованием эндоскопических техник и более распространенным применением эзофагогастродуоденоскопии с биопсией все чаще обнаруживаются как асимптомные, так и клинически важные проявления в пищеводе, желудке и двенадцатиперстной кишке. Диагноз болезни Крона с поражением верхних отделов желудочно-кишечного тракта должен базироваться на комбинации клинического анамнеза, эндоскопической и гистологической картины. Эндоскопические изменения, такие как афтоидные или продольные язвы и рисунок «бамбукового стебля», указывают на болезнь Крона, но гистологическое исследование увеличивает чувствительность диагностики заболевания, так как гистологические изменения могут присутствовать даже на эндоскопически нормальной слизистой оболочке. В то же время гистологические данные могут быть неспецифичными во многих случаях, и знание истории болезни критически важно для установления точного диагноза. В этом обзоре рассмотрены ключевые клинические, эндоскопические и гистологические характеристики болезни Крона с поражением пищевода, желудка и двенадцатиперстной кишки.
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