Occult inflammatory small-bowel disease: not so occult anymore.
Four cases are described in which reliance on small-bowel follow-through would have led to an incorrect diagnosis. In all cases, capsule endoscopy resulted in a diagnosis of inflammatory bowel disease, leading to successful treatment with mesalamine (PENTASA; Ferring Pharmaceuticals, Copenhagen, Denmark) and corresponding reductions in aphthous lesions on repeated capsule endoscopy. Based on our experience and a review of the literature, it is concluded that relying on a negative small-bowel follow-through examination to rule out small-bowel disease would be unfair to patients with suspected small-bowel disease.
Adler
Samuel Nathan
SN
Department of Gastroenterology, Bikur Cholim Hospital, Jerusalem, Israel. samadler@inter.net.il
Jacob
Harold
H
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000188:drug therapy; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine