Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety.
BACKGROUND
Capsule endoscopy (CE) is increasingly used in patients with suspected or known Crohn's disease (CD).


OBJECTIVE
To determine the diagnostic yield of CE and the distribution of small-bowel (SB) lesions in symptomatic patients with known CD.


METHODS
Retrospective review of CE procedures performed in patients with CD between 2001 and 2005 in a tertiary care center.


METHODS
One hundred thirty-four patients with an established diagnosis of CD and symptoms suggestive of active disease.


METHODS
Swallowing the capsule.


METHODS
Diagnostic yield of CE and distribution of SB lesions in patients with CD.


RESULTS
One hundred forty-six CE procedures were performed on 134 CD patients. Fifty-two (39%) of 134 patients had CE findings diagnostic of active CD (> 3 ulcerations), and 17 (13%) had findings suggestive of active CD (< or = 3 ulcerations). Fifty-seven (42%) patients had normal findings, and 6% had normal but incomplete studies. The distribution of SB lesions was 32% in the duodenum, 53% in the jejunum, 67% in the proximal ileum, and 85% in the distal ileum. CE was comparable to ileoscopy in detecting ileal ulcerations (55% vs 48%), but superior to SB follow-through in detecting CD lesions in the SB (incremental yield of 32%; 95% CI, 9%-54%; P = .0017).


CONCLUSIONS
Retrospective study from a single center.


CONCLUSIONS
CE identified SB lesions in approximately half of symptomatic CD patients. Large-scale prospective studies are needed to evaluate whether positive CE findings may affect disease outcomes.
Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Shahab
S
Mehdizadeh
Gary C
GC
Chen
Linda
L
Barkodar
Pedram J
PJ
Enayati
Shahriar
S
Pirouz
Michael
M
Yadegari
Andrew
A
Ippoliti
Eric A
EA
Vasiliauskas
Simon K
SK
Lo
Konstantinos Antonios
KA
Papadakis
D000293:Adolescent; D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D002648:Child; D003424:Crohn Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult