Endoscopic therapy for inflammatory bowel diseases(IBD)or IBD surgery-associated complications or namely interventional IBD has become the main treatment modality for Crohn’s disease,bridging medical and surgical tre...Endoscopic therapy for inflammatory bowel diseases(IBD)or IBD surgery-associated complications or namely interventional IBD has become the main treatment modality for Crohn’s disease,bridging medical and surgical treatments.Currently,the main applications of interventional IBD are(i)strictures;(ii)fistulas and abscesses;(iii)bleeding lesions,bezoars,foreign bodies,and polyps;(iv)post-operative complications such as acute and chronic anastomotic leaks;and(v)colitis-associated neoplasia.The endoscopic treatment modalities include balloon dilation,stricturotomy,strictureplasty,fistulotomy,incision and drainage(of fistula and abscess),sinusotomy,septectomy,banding ligation,clipping,polypectomy,endoscopic mucosal resection,and endoscopic submucosal dissection.The field of interventional IBD is evolving with a better understanding of the underlying disease process,advances in endoscopic technology,and interest and proper training of next-generation IBD interventionalists.展开更多
Ileal pouch-anal anastomosis surgery can be complicated by anastomotic leaks,leading to the formation of abscess and chronic sinus that have been routinely managed by a surgical approach.We developed the endoscopic ne...Ileal pouch-anal anastomosis surgery can be complicated by anastomotic leaks,leading to the formation of abscess and chronic sinus that have been routinely managed by a surgical approach.We developed the endoscopic needle knife sinusotomy(NKSi)technique,which has become a valid alternative.The basic principle of endoscopic NKSi is dissection and drainage of the sinus through its orifice internally into the lumen of pouch body.The success of NKSi requires an access to the sinus from the pouch side.One of the most challenging situations for NKSi is a closed orifice of the sinus,which leaves an isolated chronic abscess cavity.Here we report a case of complicated presacral sinus with a closed orifice that was not amenable to NKSi,necessitating a CT-guided guide wire placement and subsequent NKSi.展开更多
文摘Endoscopic therapy for inflammatory bowel diseases(IBD)or IBD surgery-associated complications or namely interventional IBD has become the main treatment modality for Crohn’s disease,bridging medical and surgical treatments.Currently,the main applications of interventional IBD are(i)strictures;(ii)fistulas and abscesses;(iii)bleeding lesions,bezoars,foreign bodies,and polyps;(iv)post-operative complications such as acute and chronic anastomotic leaks;and(v)colitis-associated neoplasia.The endoscopic treatment modalities include balloon dilation,stricturotomy,strictureplasty,fistulotomy,incision and drainage(of fistula and abscess),sinusotomy,septectomy,banding ligation,clipping,polypectomy,endoscopic mucosal resection,and endoscopic submucosal dissection.The field of interventional IBD is evolving with a better understanding of the underlying disease process,advances in endoscopic technology,and interest and proper training of next-generation IBD interventionalists.
文摘Ileal pouch-anal anastomosis surgery can be complicated by anastomotic leaks,leading to the formation of abscess and chronic sinus that have been routinely managed by a surgical approach.We developed the endoscopic needle knife sinusotomy(NKSi)technique,which has become a valid alternative.The basic principle of endoscopic NKSi is dissection and drainage of the sinus through its orifice internally into the lumen of pouch body.The success of NKSi requires an access to the sinus from the pouch side.One of the most challenging situations for NKSi is a closed orifice of the sinus,which leaves an isolated chronic abscess cavity.Here we report a case of complicated presacral sinus with a closed orifice that was not amenable to NKSi,necessitating a CT-guided guide wire placement and subsequent NKSi.
