title: Capsule endoscopy in small bowel Crohn's disease and Tuberculosis.
abstract: Differentiation of small bowel tuberculosis (SBTB) from Crohn's disease (CD) is a diagnostic challenge. We studied 52 patients with suspected SBTB or CD with terminal ileal involvement, who were prospectively enrolled. After confirming patency of the gastrointestinal tract, 26 patients underwent capsule endoscopy (CE). A final diagnosis of CD was found in 18 patients and SBTB in eight patients. All SBTB patients had involvment of the ileocecal valve (ICV) with large (n = 6) and aphthous (n = 2) ulcers in the ileal segment. In CD, ICV involvement was seen in five (33%) patients. Large and aphthous ulcers were observed in seven (47%) and 15 (100%) patients, respectively. On comparison with CD, patients with SBTB had increased frequency of ICV involvement ( P = 0.002) and lesser frequency of aphthous ulcers ( P = 0.007). CE can help in differentiating CD from SBTB by the position of its involvement and the type of ulcers present.
authors.affiliation: 1 Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Surinder Singh
authors.initials: SS
authors.lastname: Rana
authors.affiliation: 1 Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Vishal
authors.initials: V
authors.lastname: Sharma
authors.affiliation: 1 Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Sharma
authors.affiliation: 2 Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Ritambhra
authors.initials: R
authors.lastname: Nada
authors.affiliation: 3 Department of Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.affiliation: 1 Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Bhasin
mesh_terms: D000293:Adolescent; D000328:Adult; D053704:Capsule Endoscopy; D003424:Crohn Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis*; D055815:Young Adult
keywords: Crohn’s disease; Tuberculosis; aphthous ulcers; barium enteroclysis; enterography