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Significance of endoscopy in inflammatory bowel diseases in childhood
Authors:R M Bertele-Harms  H K Harms  P Schmitz-Moormann
Abstract:Endoscopy makes an essential contribution as diagnostic tool in the clarification of unspecific inflammatory bowel disease in childhood. Important advantages of this method are detection of early lesions, classification of the type of inflammation, sight-guided biopsies and no exposure to X-rays. In 36 patients the diagnosis of Crohn's disease was proven by endoscopy alone in 66.6% of cases, by histology as sole criterion in 69.4%, and by X-ray examination alone in only 8.3% of cases. All 3 patients in whom the diagnosis of Crohn's disease was made exclusively by radiological means showed manifest involvement limited to the small bowel. However, even upper gastrointestinal endoscopy led to the detection of lesions characteristic of Crohn's disease in some cases. 36 colonoscopies were performed in 28 patients with ulcerative colitis. Typical lesions were detected endoscopically in 91.7%; corresponding histological changes were found in only 63.6%.
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