title: But how many misunderstood Crohn's disease are revealed "by chance" using Capsule Endoscopy in Chronic Recurrent OGIB? Experience of a Single Italian Center and long term follow-up.
abstract: OBJECTIVE
  The role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded with greater understanding of the technology. The ability of CE to differentiate CD from other causes of inflammation has been questioned. Longitudinal studies are required to assess the long-term impact and significance of CE findings in suspected CD. The aim of this work is to verify in how many misunderstood cases of suspected Crohn's Disease CE was able to identify precociously and "by chance" when it is performed for recurrent obscure GI bleeding (OGIB), to evaluate how many of them were later confirmed during a median 24 months follow-up. Moreover, we observed the role of the early diagnosis in changing the clinical management of these patients.
  
  
  METHODS
  A retrospective review was carried out on CE procedures performed for suspected OGIB. 1008 consecutive patients was enrolled and 492 included in the study. Previous investigations such as ileo-colonoscopy and/or previous small bowel imaging were documented. Only patients with at least 6 months of documented follow-up were included. A chart review was undertaken to record CE findings/correlate with subsequent diagnosis and outcome.
  
  
  RESULTS
  94/492 (19.1%) patients positive for suspected CD were identified. Follow-up data were available 64/94 (68%). The mean follow-up was 24 months. There was a strong positive correlation between results of CE and subsequent clinical diagnosis. The suspected CD was confirmed in 100% (94/94) of follow-up patients.
  
  
  CONCLUSIONS
  CE appears able to identify lesions compatible with suspected Crohn's disease otherwise unacknowledged with consequently change in treatment options for the patients.
authors.affiliation: Department of Internal Medicine, Ospedale Belcolle, Viterbo, Italy. riurgesi@tin.it.
authors.forename: R
authors.initials: R
authors.lastname: Urgesi
authors.forename: R
authors.initials: R
authors.lastname: Cianci
authors.forename: C
authors.initials: C
authors.lastname: Marmo
authors.forename: G
authors.initials: G
authors.lastname: Costamagna
authors.forename: M E
authors.initials: ME
authors.lastname: Riccioni
mesh_terms: D053704:Capsule Endoscopy / Q000379:methods / Q000706:statistics & numerical data; D002908:Chronic Disease; D003113:Colonoscopy / Q000706:statistics & numerical data; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D033162:Incidental Findings; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies