Pouchitis atlas for objective endoscopic diagnosis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2007-10-15

AUTHORS

Kouhei Fukushima, Hisao Fujii, Takehira Yamamura, Akira Sugita, Shingo Kameoka, Hirokazu Nagawa, Kitaro Futami, Toshiaki Watanabe, Katsuyoshi Hatakeyama, Toshio Sawada, Kazuhiko Yoshioka, Masato Kusunoki, Fumio Konishi, Masahiko Watanabe, Ken-Ichi Takahashi, Hitoshi Ogawa, Yuji Funayama, Toshifumi Hibi, Iwao Sasaki, for the Surgical Research Group, the Research Committee of Inflammatory Bowel Disease, Ministry of Health, Labour and Welfare of Japan

ABSTRACT

“Pouchitis” is a term for nonspecific mucosal inflammation of the pouch after total proctocolectomy and ileal pouch–anal anastomosis for ulcerative colitis. Pouchitis is the most frequent complication of the pelvic pouch at the late stage. To improve the accuracy of the pouchitis diagnosis, sets of clinical symptoms and endoscopic findings (with or without histology of biopsy samples) have previously been evaluated. Endoscopic findings are central to the diagnosis, and a universal consensus of various endoscopic findings must be the initial step toward an objective diagnosis of pouchitis. Since a proper signpost for the endoscopic evaluation of pouchitis has been absent, we developed this pouchitis atlas to minimize the diagnostic variation inherent among individual endoscopists. We also propose new criteria for the diagnosis of pouchitis: the Japanese criteria for diagnosis of pouchitis. These criteria are based on clinical symptoms and endoscopic findings that are clearly categorized in the atlas, and exclude infectious enteritis, anastomotic insufficiency, pelvic infection, anal dysfunction, and Crohn's disease. Advantages of the new criteria include ease of bedside diagnosis, without the calculation of points required by the other criteria for pouchitis. This pouchitis atlas, together with our new criteria, should contribute to the establishment of a clear-cut diagnosis for pouchitis and promote better evaluation and treatment of this novel intestinal inflammation. More... »

PAGES

799-806

Journal

TITLE

Journal of Gastroenterology

ISSUE

10

VOLUME

42

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00535-007-2083-3

DOI

http://dx.doi.org/10.1007/s00535-007-2083-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1004091113

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/17940832


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20 schema:description Abstract“Pouchitis” is a term for nonspecific mucosal inflammation of the pouch after total proctocolectomy and ileal pouch–anal anastomosis for ulcerative colitis. Pouchitis is the most frequent complication of the pelvic pouch at the late stage. To improve the accuracy of the pouchitis diagnosis, sets of clinical symptoms and endoscopic findings (with or without histology of biopsy samples) have previously been evaluated. Endoscopic findings are central to the diagnosis, and a universal consensus of various endoscopic findings must be the initial step toward an objective diagnosis of pouchitis. Since a proper signpost for the endoscopic evaluation of pouchitis has been absent, we developed this pouchitis atlas to minimize the diagnostic variation inherent among individual endoscopists. We also propose new criteria for the diagnosis of pouchitis: the Japanese criteria for diagnosis of pouchitis. These criteria are based on clinical symptoms and endoscopic findings that are clearly categorized in the atlas, and exclude infectious enteritis, anastomotic insufficiency, pelvic infection, anal dysfunction, and Crohn's disease. Advantages of the new criteria include ease of bedside diagnosis, without the calculation of points required by the other criteria for pouchitis. This pouchitis atlas, together with our new criteria, should contribute to the establishment of a clear-cut diagnosis for pouchitis and promote better evaluation and treatment of this novel intestinal inflammation.
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