The Role of Endoscopy in Celiac Disease and its Complications: Advances in Imaging Techniques and Computerization

Adolfo Parra-Blanco, Carlos Agüero, Daniel Cimmino, Nicolás González, Patricio Ibáñez, Silvia Pedreira

Resumen


Endoscopy, for many reasons, is an important technique in the diagnosis of celiac disease (CD), since it is currently the most widely used method for performing duodenal biopsies. On the other hand, certain changes in the duodenal mucosa must warn the endoscopist of a possible celiac disease. This is relevant, since it is well-known that most of the people who have this disease remain undiagnosed. With the development of endoscopy, different markers can be used to predict the existence of villous atrophy, but a high level of suspicion is required. The correct application of guidelines performing biopsies for a celiac disease diagnosis, especially if there is a sufficient number of samples, is important to reach diagnosis. Besides, due to the fact that the spectrum of health problems related to celiac disease is quite wide, their possible association must be taken into account and the performance of duodenal biopsies must be encouraged. This last decade’s technological achievements have greatly facilitated the study of the small intestine via endoscopy. Even if these advanced techniques are generally unnecessary in most cases, there are some of them in which the video capsule and/or enteroscopy allow to achieve a diagnosis, especially in refractory celiac disease cases. Other cutting-edge techniques, such as digital chromoendoscopy, optical coherence tomography and confocal endomicroscopy could be useful to predict the existence of villous atrophy and some of them could even help the endoscopist recognize lesser degrees of celiac disease. The relevance of these techniques in daily practice remains to be dilucidated.

Palabras clave


celiac, endoscopy, image technique, computerization

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