Wireless capsule endoscopy versus enteroclysis in the diagnosis of small-bowel Crohn's disease.
OBJECTIVE
The aim of this study was to prospectively compare the diagnostic yield of wireless capsule endoscopy (WCE) and enteroclysis in the detection of Crohn's disease (CD) of the small bowel.


METHODS
Twenty-nine patients with known CD (group 1) suspected to have more extensive small-bowel involvement and 26 patients, who were suspected to suffer from CD but did not have an earlier history of it (group 2) were prospectively evaluated with enteroclysis and WCE. Each examiner was blinded to the results of other investigations.


RESULTS
Enteroclysis was unsuccessful in two patients from group 1 8 and six patients from group 2, respectively. In group 1, abnormal findings consistent with CD were detected in 20 patients by using WCE and in 11 patients by using enteroclysis, out of the total 27, at per-protocol analysis (74.1 vs. 40.7%, P<0.05). Of the 11 patients who had ileal CD on enteroclysis, three had more extensive small-bowel disease, which was detected only by WCE. In group 2, WCE showed findings consistent with CD in 13 of 20 patients, in contrast with enteroclysis, which was positive for CD in only six of 20 patients (65 vs. 30%, P<0.05). Three more patients had findings compatible with CD on WCE, but they failed their enteroclysis. Overall, a new diagnosis of CD was made in 16 patients.


CONCLUSIONS
WCE has a higher diagnostic yield than enteroclysis in the detection of CD of the small bowel, both in patients with known and newly suspected CD.
Efthymiou
Alkiviadis
A
2nd Department of Gastroenterology, Evangelismos General Hospital, Athens, Greece. a_efthimiou@hotmail.com
Viazis
Nikos
N
Vlachogiannakos
Jiannis
J
Georgiadis
Dimosthenis
D
Kalogeropoulos
Ioannis
I
Mantzaris
Gerassimos
G
Karamanolis
Dimitrios G
DG
D000293:Adolescent; D000328:Adult; D053704:Capsule Endoscopy / Q000379:methods*; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
D003287:Contrast Media