Capsule endoscopy findings in patients with established and suspected small-bowel Crohn's disease: correlation with radiologic, endoscopic, and histologic findings.
BACKGROUND
Little is known about the accuracy of capsule endoscopy (CE) in evaluation of small-bowel Crohn's disease.


METHODS
Symptomatic eligible patients had ileocolonoscopy and biopsies from the terminal ileum, followed by small-bowel radiologic studies before CE. Endoscopic, radiologic, CE, and histologic findings were compared. Histology (terminal ileum biopsy specimens or a tissue sample after small-bowel resection) served as a criterion standard.


RESULTS
Fifty-four patients were enrolled; 15 of the 54 patients were excluded from data analysis (critical small-bowel strictures, 14, identified on radiology; incomplete CE, 1). Data were analyzed for 39 patients. All patients had histologic evaluation of the small bowel. Final diagnosis of active small-intestine Crohn's disease was made in 29/39 patients (74.4%). When calculated, CE yielded a sensitivity and a specificity of 89.6% and 100.0%, respectively, and a positive predictive value and a negative predictive value of 100.0% and 76.9%, respectively, whereas small-bowel series were 27.6%/100.0% and 100.0%/32.3%.


CONCLUSIONS
CE is more accurate in detecting small-bowel inflammatory changes suggestive of Crohn's disease than conventional studies. CE, combined with ileocolonoscopy, may be proposed as a first-line investigation of the small intestine in cases of uncomplicated known or suspected Crohn's disease.
Dubcenco
Elena
E
Division of Gastroenterology, Department of Radiology, St. Michael's Hospital, Toronto, Ontario, Canada.
Jeejeebhoy
Khursheed N
KN
Petroniene
Rima
R
Tang
Shou-jiang
SJ
Zalev
Arthur H
AH
Gardiner
Geoffrey W
GW
Baker
Jeffrey P
JP
D000328:Adult; D001706:Biopsy; D003424:Crohn Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004733:Enema; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007079:Ileitis / Q000175:diagnosis*; D007082:Ileum / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008747:Methylcellulose; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D013686:Telemetry
D008747:Methylcellulose