BALLOON ENDOSCOPY TO EXAMINE SMALL INTESTINAL LESIONS IN PATIENTS WITH CROHN’S DISEASE

Abstract

Small intestinal lesions in Crohnʼs disease can cause obstructions and are known to have a high surgery rate. Management of small intestinal lesions is essential in treating Crohnʼs disease. In clinical practice, balloon-assisted endoscopy can assist with diagnosing Crohnʼs disease, which presents with lesions in areas that are difficult to visualize with a conventional ileocolonoscopy, and facilitate evaluation and monitoring of therapeutic effects on small bowel lesions. In addition, balloon dilation for symptomatic small bowel stricture has been reported to have a high procedural success rate and favorable long-term efficacy in lesions that meet the indication criteria, such as the absence of ulcers. Compared to other methods of evaluating small lesions, it has high accuracy for detecting small intestinal lesions and is the only method that enables tissue biopsy and endoscopic treatment. On the other hand, it is invasive, and adverse events such as gastrointestinal perforation, bleeding, and pancreatitis have been reported. In clinical practice, future discussions are expected on case-dependent selection of an optimal modality among various available modalities for evaluation and management of Crohnʼs disease, including balloon-assisted endoscopy.