title: [Evaluation of small bowel involvement in Crohn's disease by small- bowel videocapsule endoscopy: a prospective comparative study with computed-tomography enteroclysis and small bowel radiography].
abstract: BACKGROUND
  Small-bowel videocapsule endoscopy (VCE) is a new technique in evaluation of intestinal involvement in several pathologies. Crohn's disease affects principally terminal ileum. Small bowel involvement in Crohn's disease is not well estimated by endoscopic and radiologic conventional techniques.
  
  
  OBJECTIVE
  To evaluate the performances of VCE in detection of asymptomatic proximal small bowel lesions in consecutive patients with Crohn's disease with terminal ileal involvement, to compare the results of VCE to small bowel radiography and CT-enteroclysis and to determine the therapeutic impact of VCE in these patients.
  
  
  METHODS
  A prospective study which included Crohn's disease patients with distal ileal involvement, based on radiological or endoscopic findings. We performed in all patients small bowel radiography, CT enteroclysis and VCE. Proximal involvement was characterized by presence of aphtoid, superficial or deep ulcerations in the jejunum or the proximal ileum.
  
  
  RESULTS
  We studied 20 patients (12 men, mean age 31.6 years). VCE confirmed the distal ileal involvement in all patients. Significative proximal lesions was observed in nine patients (jejunum only: one case, jejunum and ileum: six cases and proximal ileum: two cases), in most cases aphtoid or superficial lesions. Deep ulcerations were observed in two patients. Small bowel radiography showed proximal ileal lesions in only two patients, and CT-enteroclysis in only one patient. Treatment by azathioprine was prescribed in two patients with severe and extended small bowel lesions in VCE examination.
  
  
  CONCLUSIONS
  VCE is more accurate than radiologic techniques in detection of small bowel lesions in Crohn's disease. In cases of severe and extended small bowel involvement, VCE can conduct to changes of therapeutic approach.
authors.affiliation: Hopital la Rabta, Tunis, Tunisie.
authors.forename: Sami
authors.initials: S
authors.lastname: Karoui
authors.forename: Soukaina
authors.initials: S
authors.lastname: Ouerdiane
authors.forename: Kais
authors.initials: K
authors.lastname: Nouira
authors.forename: Meriem
authors.initials: M
authors.lastname: Serghini
authors.forename: Nadia
authors.initials: N
authors.lastname: Ben Mustapha
authors.forename: Lamia
authors.initials: L
authors.lastname: Kallel
authors.forename: Monia
authors.initials: M
authors.lastname: Fekih
authors.forename: Samira
authors.initials: S
authors.lastname: Matri
authors.forename: Jalel
authors.initials: J
authors.lastname: Boubaker
authors.forename: Emna
authors.initials: E
authors.lastname: Mnif
authors.forename: Azza
authors.initials: A
authors.lastname: Filali
mesh_terms: D000293:Adolescent; D000328:Adult; D053704:Capsule Endoscopy / Q000379:methods*; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult