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Utredning och diagnostik av PIBD
Petter Malmborg ALB
Portokriterierna II
Portokriterierna I
Inflammatory bowel disease in
children and adolescents:
recommendations for diagnosis-the
Porto criteria.
IBD Working Group of the European Society for
Paediatric Gastroenterology, Hepatology and
Nutrition.
J Pediatr Gastroenterol Nutr. 2005 Jul;41(1):1-7.
Portokriterierna I
Diagnosis of IBD is based on
Clinical signs and symptoms
Endoscopy and histology and radiology
Every child suspected of IBD should undergo
Colonoscopy with ileal intubation
Upper gastrointestinal endoscopy
Radiologic contrast imaging of the small bowel
(except in definite ulcerative colitis).
ECCO statements 2009 & 2012
Gold standards for the diagnosis of
CD or UC is not yet available.
Lennard-Jones-kriterierna
För att ställa diagnosen IBD skall annan orsak till den
påvisade tarminflammationen ha uteslutits:
Infektion
Malignitet
Ischemi
Lennard-Jones JE.
Classification of inflammatory bowel disease.
Scand J Gastroenterol Suppl. 1989;170:2-6
Köpenhamnskriterierna
Diagnostic criteria for UC (all 3 criteria must be present)
1. History of diarrhoea and/or rectal bleeding and pus for more than 1 week
or repeated episodes.
2. Characteristic endoscopic findings of continuous ulceration, vulnerability,
or granulated mucosa.
3. Histopathology consistent with UC
Infection and cancer must have been ruled out.
Ulcerative colitis. An epidemiological study based on a regional inception
cohort, with special reference to disease course and prognosis.
Langholz E. Dan Med Bull 1999;46(5):400‐15.
Köpenhamnskriterierna
Diagnostic criteria for CD (2 of 4 criteria must be present)
1. History of abdominal pain, weight loss, and/or diarrhoea for more than 3
months.
2. Characteristic endoscopic or radiologic findings of ulceration,
cobblestoning or stricture.
3. Histopathology consistent with CD.
4. Fistulas and/or abscesses in addition to an affected bowel segment.
Infection and cancer must have been ruled out.
Crohn's disease‐occurrence, course and prognosis.
Munkholm P.
Dan Med Bull 1997;44(3):287‐302.
Portokriterierna II
Antal barn-ungdomar som insjuknar i IBD per 100 000
innevånare och år
12
10
8
UC
6
CD
4
2
0
Northern Stockholm South -Eastern Norway Eastern Denmark Southern Finland
2002-07
2007-09
2007-09
2003
Differentiating ulcerative colitis from Crohn
disease in children and young adults
North American Society for Pediatric
Gastroenterology, Hepatology, and Nutrition;
Colitis Foundation of America,
Bousvaros A, Antonioli DA, Colletti RB, et al
J Pediatr Gastroenterol Nutr. 2007
May;44(5):653-74.