Balloon Assisted Enteroscopy Is an Emerging Tool in the Management of Crohnʼs Disease
Notice bibliographique
Résumé
Introduction: Seventy percent of CD patients suffer from small bowel involvement and up to 30% have isolated small bowel disease. Double and Single Balloon Enteroscopy (DBE and SBE, respectively) allow for improved visualization and for therapeutic intervention. This study aims to investigate the efficacy and safety of both procedures - Balloon Assisted Enteroscopy (BAE) - in patients with known or suspected small-bowel CD. Methods: A retrospective chart review was undertaken to examine all patients with small-bowel CD who underwent BAE over the last 4 years. Patient demographics (age at operation, duration of disease), disease characteristics (location, complication), surgical history, previous imaging (CTE, MRE, SBFT, VCE), procedure characteristics (indications, findings, therapy, safety, outcomes), and stricture dilation data were all recorded. Results: 56 BAEs (45 Anal, 10 oral, 1 stomatal) were performed on 32 patients (19 Male). The mean age at BAE was 46.5 years. 45 (83%) of procedures were on patients with known CD, 9 (17%) were on patients to establish a new diagnosis. 27 (84%) of patients had ileal CD, 2 (6%) had jejunal, and 3 (9%) had both. 19 (59%) of patients had at least one previous bowel resection. CTE was the most frequently used imaging modality with 26 (82%) patients having had a previous scan; 20 (77%) showed positive findings for CD, 6 (30%) showed negative findings and did not agree with the BAE findings. Small bowel strictures were found in 21 (65%) patients on BAE; 14 (44%) paitents underwent 22 BAE procedures and 48 balloon-assisted stricture dilations were perofrmed. The average diameter of dilation was 16 mm; 9 strictures were considered non-traversible. Complications occured in 2 (4%) BAE procedures; 1 patient developed acute pancreatitis, the other had minor bleeding post-dilation. There were no perforations or deaths. Conclusion: Balloon assisted enteroscopy is a safe and effective procedure for visualization and treatment of small bowel CD and is likely under-utilized as an endoscopic tool. BAE provides the ability to directly visualize small bowel CD beyond simple ileal intubation. Stricture dilation via BAE is a safe procedure that can alleviate obstructive symptoms for both patients who have had previous resections or those with primary stenosis. The combination of therapeutic intervention and direct and extensive mucosal visualization makes BAE the optimal modality for diagnosis and treatment of small bowel CD.Table 1: Demographics for Patients with Known or Query Crohn's undergoing Balloon Assisted EnteroscopyTable 144b: Comparison of Imaging Modalities to Balloon Assisted Enteroscopy findings in Patients with Known or Query Crohn's Disease
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».