title: Capsule endoscopy vs. push enteroscopy and enteroclysis in suspected small-bowel Crohn's disease.
abstract: BACKGROUND
  The diagnosis of small-bowel Crohn's disease sometimes is difficult and may be missed by conventional imaging studies. Capsule endoscopy might identify small-bowel disease undetected by other investigations.
  
  
  METHODS
  Patients with or without known Crohn's disease who were suspected to have small-bowel Crohn's disease were prospectively evaluated with push enteroscopy, enteroclysis, and capsule endoscopy. Each examiner was blinded to results of other investigations. Referring doctors were required to complete questionnaires before and after the investigations.
  
  
  RESULTS
  Twenty-two patients were known to have Crohn's disease (Group 1), and 21 were suspected to have small-bowel Crohn's disease (Group 2). In Group 1, capsule endoscopy detected more erosions than the other two investigations (p < 0.001). In Group 2, a new diagnosis of Crohn's disease was made in two patients, but there was no significant difference in yield compared with the other two investigations. Referring physicians rated the usefulness of capsule endoscopy as 4.4 on a scale of 5. Capsule endoscopy changed management for 30 patients (70%).
  
  
  CONCLUSIONS
  Capsule endoscopy has a higher yield than push enteroscopy and enteroclysis in patients with known Crohn's disease when small-bowel mucosal disease is suspected, and this leads to a change in management in the majority of these patients.
authors.forename: André Kheng Ho
authors.initials: AK
authors.lastname: Chong
authors.forename: Andrew
authors.initials: A
authors.lastname: Taylor
authors.forename: Ashley
authors.initials: A
authors.lastname: Miller
authors.forename: Oliver
authors.initials: O
authors.lastname: Hennessy
authors.forename: William
authors.initials: W
authors.lastname: Connell
authors.forename: Paul
authors.initials: P
authors.lastname: Desmond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003424:Crohn Disease / Q000175:diagnosis*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D011446:Prospective Studies; D016037:Single-Blind Method