Methods of instrumental diagnostics of Crohn's disease
The importance of the diagnosis of the disease have radiological examinations - irrigoscopy, continuous X-ray of the small intestine.
Irrigoscopy - X-ray examinationfilling the colon with its radiopaque suspension through the anus. This method of research must necessarily precede sigmoidoscopy because the X-ray examination methods do not reveal the final pathology of the rectum. Barium enema reveals tumors, diverticula, fistulas, ravitiya defects and strictures (narrowing) of the colon. The method is absolutely painless and is performed without anesthesia.
As radiopaque agentsan aqueous slurry of barium sulfate. Radiopaque podgrevayut slurry to 33-35 ° and is introduced into the colon via Bobrov apparatus through a rubber tube without a hard tip. Under fluoroscopic guidance is gradually filled with radiopaque suspension of the colon and produce a survey and sighting shots all its departments in different positions of the patient. In the next step, after removal of the colon radiopaque slurry examined relief mucosa. At the final stage of barium enema, especially in cases of suspected tumor of the colon, a study conducted at a dosed colon filled with air, using the apparatus Bobrova (barium enema with double contrast).
Endoscopic studies(Colonoscopy, sigmoidoscopy) are most useful in the diagnosis of Crohn's disease with colonic lesions. Irregular thickening of the mucosa, the presence of narrow-cracks ulcers, narrowing of the intestinal lumen - painting "cobblestones", is characteristic of Crohn's disease. However, in the initial stages of the disease and the formation of scar tissue like a typical picture can not be obtained. Biopsy, performed during endoscopy can confirm the diagnosis. Nevertheless detect characteristic of Crohn's disease sarkoidopodobnye granuloma is not always possible.
Ultrasound examination of the abdominal cavity,CT scans provide valuable information for the diagnosis of abscesses, often a complication of Crohn's disease. In the presence of external fistulas shown holding fistulography.
Colonoscopy is the most informative methoddiagnosis of colon diseases. In most cases, it allows to inspect the colon throughout. During colonoscopy visually estimated state colonic mucosa, that allows to detect early stages of benign and malignant tumors of the colon, inflammatory diseases, etc. Colonoscopy is carried out with the help of special devices - colonoscope, which is a flexible tube with fiber optics. This procedure is quite painful for the patient, so it is possible to hold under anesthesia.
Sigmoidoscopy is a must viewexamination of the patient, ask for help to the proctologist. It is carried out after a preliminary study of finger rectum to avoid diseases that make the procedure dangerous or impossible (stricture and deformation of the rectum).
Relative to the implementation of protivopokzaniemprocedures are also the presence of acute hemorrhoids, anal fissure and acute abscess with severe pain. In this case, sigmoidoscopy is best done after decrease in acute period. Proctoscope is a metallic hollow tube of 20-30 cm length, which through a flexible optical fiber connected to the optical lighter. In the knee-elbow position proctoscope inserted into the patient's rectum and allows you to inspect it, and part of the sigmoid colon. The procedure is performed without anesthesia and lasts for several minutes.