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• W2008517070 abstract "Colonoscopy is performed in patients with Crohn's disease (CD) for estimating disease activity. However, colonoscopic examination is often incomplete in CD patients because of colon stricture. This study was conducted to evaluate the additional role of using a gastroscope in CD patients who failed colonoscopy due to stricture. Among 1501 CD patients who had been registered in Asan Medical Center from January 1991 through December 2009, we enrolled 76 patients who had failed complete colonoscopy due to stricture. In 76 patients, 101 colonoscopies were performed with gastroscope to complete the examination. Complete colonoscopy was defined as evaluation up to cecum or anastomotic site of the ileo-cecal or colon resection. The patients were composed of 36 (47.3%) men and 40 women. The age at diagnosis of CD ranged from 17 to 40 years in 60 (78.9%) of 76 patients. Mean disease duration of 101 cases at using a gastroscope for colonoscopy (GFC) was 6.8 ± 4.7 (0 - 19.2) years. The most common reason for examination was surveillance (63.3%). About a half of cases had a history of peri-anal disease (56.4%) and bowel surgery (47.5%). The mean CDAI and CRP at using a GFC were 198 ± 101 (2 - 466) and 1.7 ± 1.9 (0 - 10.0) mg/dL, respectively. In majority of the cases, 5-ASA, antibiotics, corticosteroids, and immunosuppressants had been administered before using a GFC, and 5-ASA and immunosuppressants at using a GFC. The levels of failed colonoscopies were anus in 35 (34.7%) of 101 cases, rectum in 34 (33.7%), sigmoid colon in 27 (26.7%), descending colon in 3 (3.0%), transverse colon in 1 (1.0%), and ascending colon in 1 (1.0%), respectively. Complete examinations with GFC were possible in 71 (70.3%) of 101 cases, and we were able to evaluate more proximal portion with GFC than colonoscopy in 18 cases. Totally, additional evaluation was given through GFC in 89 (88.1%) of 101 cases. No complications occurred after using a GFC. We found active lesions in 55 (61.8%) of 89 cases; aphthous ulcers in 5 (5.6%), medium sized ulcers in 22 (24.7%), large, longitudinal or serpiginous ulcers in 27 (30.3%), and one (1.1%) rectal cancer with biopsy, respectively. After using a GFC, 33 (37.1%) of 89 cases changed medications. In CD patients with incomplete colonoscopy due to stricture, using a GFC could evaluate the whole colon in about 70% of cases. Furthermore, it provided an additional information on disease state in about 90% of cases. By using a GFC, we could confirm active lesions in about 60% of cases and a cancer. These findings suggest that using a gastroscope for an incomplete colonoscopy should be considered in patients with structuring CD." @default.
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• W2008517070 date "2011-04-01" @default.
• W2008517070 modified "2023-09-23" @default.
• W2008517070 title "Sa1584 Using a Gastroscope for an Incomplete Colonoscopy in Patients With Stricturing Crohn's Disease" @default.
• W2008517070 doi "https://doi.org/10.1016/j.gie.2011.03.319" @default.
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