Ileoscopy (eBook)

Ileoscopy 2
Foreword 5
Preface 6
Acknowledgments 7
Contents 8
Contributors 10
1 Terminal Ileoscopy: Technique 13
1.1…Introduction 13
1.2…Anatomy of the Ileocecal Region 13
1.3…Ileocecal Valve Appearances 14
1.4…Ileoscopy: Technique 14
1.4.1 Magnified Ileoscopy 16
1.4.2 Virtual Chromoendoscopy 16
1.5…Conclusions 17
References 18
2 The Importance of Complete Colonoscopy and Exploration of the Cecal Region 19
2.1…The Importance of a Complete Colonoscopy 19
2.2…The Importance of Exploring the Cecum 20
2.3…Case Presentation 20
2.3.1 Case 1 20
2.3.2 Case 2 20
References 22
3 What are the Correct Indications for Ileoscopy? 24
3.1…Introduction 24
3.2…Indications and Results of Terminal Ileoscopy 24
3.3…The Contribution of Histology 25
3.4…Open Issues 28
3.5…Conclusions 29
References 29
4 Contribution of New Technologies to Endoscopic Imaging 31
4.1…Introduction 31
4.2…High-Resolution and High-Magnification Endoscopy 31
4.2.1 Technological Status 31
4.2.2 Implementation of High-Resolution and High-Magnification Endoscopy in Ileoscopy 32
4.3…Computed Virtual Chromoendoscopy 33
4.3.1 Technological Status 33
4.3.2 Implementation of Computed Virtual Chromoendoscopy in Ileoscopy 35
4.4…Confocal LASER Endoscopy 36
4.4.1 Technological Status 36
4.4.2 Implementation of Confocal Laser Endoscopy in Ileoscopy 37
References 37
5 Ileoscopy in Coeliac Disease 40
5.1…Introduction 40
5.2…Videocapsule and Capsule Endoscopy in the Evaluation of Celiac Disease 40
References 41
6 The Role of Ileoscopy in Inflammatory Bowel Disease 43
6.1…Introduction 43
6.2…Endoscopic Evaluation in Crohn’s Disease 43
6.3…Endoscopic Evaluation in Ulcerative Colitis 44
6.4…Conclusions 47
References 47
7 Ileoscopy in the Diagnosis of Infectious Diseases 49
7.1…Introduction 49
7.2…Intestinal Tuberculosis 49
7.3…Ileal Bacterial Infections 50
7.4…Ileal Protozoal Infections 52
7.5…Ileal Fungal and Parasitic Infections 52
7.6…Conclusions 53
References 53
8 Results of Ileoscopy in Pediatric Patients 55
8.1…Traditional Ileoscopy 55
8.2…Capsule Endoscopy and Small-Bowel Enteroscopy 56
8.3…Intraoperative Ileoscopy and Indications for Surgery in Small-Bowel Diseases 58
8.4…Surgically Assisted Ileoscopy 58
References 59
9 The Role of Histology in Small Bowel Diseases 61
9.1…Introduction 61
9.2…Inflammatory Bowel Disease 61
9.3…Ischemia--Actinic Ileocolitis 63
9.4…Celiac Disease 63
9.5…Rare Pathological Entities 65
9.6…Tumors 65
References 65
10 Radiological Diagnosis of Small-Bowel Diseases 67
10.1…Introduction 67
10.2…Direct Abdominal Radiography 67
10.3…Small-Bowel Follow-Through Study and Peroral Pneumocolon 67
10.4…Enteroclysis 67
10.5…Ultrasound Appearance of Crohn’s Disease and Malignancies 68
10.6…Computed Tomography Studies of Small-Bowel Disease 68
10.6.1 CT and Clinical Disease Activity 70
10.6.2 CT Versus Ileocolonoscopy in Evaluating Recurrent Crohn’s Disease 70
10.7…MRI Evaluation of Small-Bowel Disease 71
10.8…Conclusions 71
References 72
11 Capsule Endoscopy: The Answer to a Challenge 73
11.1…Introduction 73
11.2…Indications and Results 73
11.2.1 Obscure Gastrointestinal Bleeding 74
11.2.2 Crohn’s Disease 75
11.2.3 Small-Bowel Tumors 76
11.2.4 Celiac Disease 77
11.2.5 Miscellanea 77
11.3…Open Issues 77
11.4…Conclusions 78
References 78
12 Double-Balloon Enteroscopy 80
12.1…Enteroscopy: An Overview 80
12.2…Double-Balloon Enteroscopy 80
12.2.1 Double-Balloon Endoscopy Systems 81
12.2.2 Technique 81
12.3…Indications 82
12.4…Results Obtained in the Major Indications 82
12.4.1 Obscure Gastrointestinal Bleeding 82
12.4.2 Crohn’s Disease 83
12.4.3 Celiac Disease and Unexplained Malabsorption 83
12.4.4 Tumors 83
12.5…Route Selection 84
12.6…Complications 84
12.7…Future Perspectives 84
References 84
13 Single-Balloon Enteroscopy 86
13.1…Background 86
13.2…The Single-Balloon Enteroscope System 86
13.3…Preparation 87
13.4…Sedation 87
13.5…Insufflation of Gas 88
13.6…Determination of the Primary Insertion Route 88
13.7…Fluoroscopic Control 88
13.8…Procedure 88
13.8.1 Balloon-Assisted Enteroscopy by the Anterograde Approach 88
13.8.2 Balloon-Assisted Enteroscopy by the Retrograde Approach 90
13.9…Complications 90
13.10…Clinical Cases 90
13.11…Summary 92
References 92
14 Spiral Enteroscopy 93
14.1…Background 93
14.2…Endo-Ease Discovery SB Overtube 93
14.3…Endo-Ease Vista Retrograde 93
14.4…Anterograde Spiral Enteroscopy: Technique 94
14.5…Sedation 95
14.6…Spiral Enteroscopy Studies 95
14.7…Summary 96
References 96
15 Surgery for Small-Bowel Disease 97
15.1…Congenital Malformations 97
15.2…Diverticula 98
15.2.1 Meckel’s Diverticulum 98
15.2.2 Diverticulosis 99
15.3…Small-Bowel Obstruction 99
15.3.1 Occlusion 99
Adhesion-Related Occlusion 99
Intraluminal Occlusion 99
Parietal Occlusion 100
15.3.2 Strangulation 101
Small-Bowel Volvulus 101
Strangled Primitive and Incisional Hernias 101
15.3.3 Intussusception 102
15.3.4 Obstruction from Other Organic Causes 102
15.3.5 Functional Obstructions 103
15.4…Crohn’s Disease 103
15.5…Neoplasms 105
15.5.1 Benign Neoplasms 105
15.5.2 Malignant Neoplasms 105
15.6…Acute Mesenteric Ischemia 106
15.6.1 Mesenteric Arterial Occlusion 106
15.6.2 Mesenteric Venous Thrombosis 106
15.6.3 Non-occlusive Mesenteric Ischemia 107
References 107
Index 109