152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

Fig. 13
Diagnosis: Crohn’s disease
• Characteristic pattern of inflammation
Esophagus, stomach,
duodenum 3–5 %
Small bowel 25–30 %
Small and large bowel 40–55 %
Rectum 11–26 %
I Endoscopy in IBD – Crohn’s disease (F. Hartmann, Frankfurt)
40–55% of patients (figure 13), while rectal
involvement is seen in 11–26% of patients.
Thanks to endoscopy, a reliable differential diagnosis
is possible in most cases and IBD can be
distinguished from infectious enteritis, drug-induced
enterocolitis, mesenteric ischemia, diverticulitis
and malignant disease.
This does not, however, represent the limits of
endoscopy. “We cannot only inspect the mucosa,
but also obtain biopsies,” F. Hartmann said. In
his opinion, the strength of endoscopy lies in its
capacity to monitor the disease course, especially
with regard to the possible development of dysplasias.
He was more guarded in his assessment
of the new developments in endoscopy, noting
that “I do not believe that we need capsule endoscopy
to reliably diagnose Crohn’s disease.”
Congress Short Report Falk Symposium 152
P.N. Meier
Special care is required in children
Special conditions apply to pediatrics, P.N. Meier
(Hannover) explained. One must always consider
the special situation of children who, while they
may not directly fear the endoscopic procedure,
are more prone to anxiety at being separated
from their parents. There are also some practical
issues involved, such as the fact that children are
not able to remain abstinent from food for long
periods. “They should always be examined early
in the morning,” P.N. Meier noted. Wherever
possible, the procedure should be conducted
under general anesthesia. With the exception of
newborns and young children, P.N. Meier said,
special endoscopy units are not required. Good
cooperation between the pediatrician and the
consulting gastroenterologist is essential.
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