Small bowel involvement in Crohn's disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis.
BACKGROUND
Wireless capsule endoscopy (WCE) offers endoscopic access to the small bowel and may therefore change diagnostic and therapeutic strategies in small bowel diseases.


OBJECTIVE
The aim of this prospective study was to validate the gain in information and therapeutic impact of WCE in patients with Crohn's disease.


METHODS
Fifty six consecutive patients with Crohn's disease underwent computed tomography (CT) enteroclysis, and if stenoses <10 mm were excluded, WCE was carried out.


RESULTS
In 15 patients (27%), WCE could not be performed due to strictures detected by CT enteroclysis. From the other 41 patients, jejunal or ileal lesions were found in 25 patients by WCE compared with 12 by CT enteroclysis (p=0.004). This gain in information was mainly due to detection of small mucosal lesions such as villous denudation, aphthoid ulcerations, or erosions. Both methods were not significantly different in the detection of lesions in the terminal/neoterminal ileum (WCE 24 patients, CT enteroclysis 20 patients). Therapy was changed due to WCE findings in 10 patients. Consecutively, all of them improved clinically.


CONCLUSIONS
Capsule endoscopy improves the diagnosis of small bowel Crohn's disease. This may have significant therapeutic impact.
Voderholzer
W A
WA
Medical Clinic IV-Gastroenterology/Hepatology/Endocrinology/Metabolism, Charité University Hospital, Humboldt University, Berlin, Germany. winfried.voderholzer@charite.de
Beinhoelzl
J
J
Rogalla
P
P
Murrer
S
S
Schachschal
G
G
Lochs
H
H
Ortner
M-A
MA
D000328:Adult; D002214:Capsules; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D007579:Jejunal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D011446:Prospective Studies; D013686:Telemetry / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed
D002214:Capsules