Wireless capsule endoscopy and proximal small bowel lesions in Crohn's disease.
OBJECTIVE
To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn's disease (CD).


METHODS
WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis.


RESULTS
WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidal anti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (chi(2) = 1.5, P = 0.2).


CONCLUSIONS
The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum.
Petruzziello
Carmelina
C
GI Unit, Department of Internal Medicine, University Tor Vergata, Rome 00133, Italy.
Onali
Sara
S
Calabrese
Emma
E
Zorzi
Francesca
F
Ascolani
Marta
M
Condino
Giovanna
G
Lolli
Elisabetta
E
Naccarato
Paola
P
Pallone
Francesco
F
Biancone
Livia
L
D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D016022:Case-Control Studies; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014456:Ulcer / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult
D003287:Contrast Media