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Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety.
Gastrointest Endosc. 2010 Jan; 71(1):121-7.GE

Abstract

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.

DESIGN AND SETTING

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

PATIENTS

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

INTERVENTIONS

Swallowing the capsule.

MAIN OUTCOME MEASUREMENTS

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).

LIMITATIONS

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.

Authors+Show Affiliations

Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19863957

Citation

Mehdizadeh, Shahab, et al. "Capsule Endoscopy in Patients With Crohn's Disease: Diagnostic Yield and Safety." Gastrointestinal Endoscopy, vol. 71, no. 1, 2010, pp. 121-7.
Mehdizadeh S, Chen GC, Barkodar L, et al. Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety. Gastrointest Endosc. 2010;71(1):121-7.
Mehdizadeh, S., Chen, G. C., Barkodar, L., Enayati, P. J., Pirouz, S., Yadegari, M., Ippoliti, A., Vasiliauskas, E. A., Lo, S. K., & Papadakis, K. A. (2010). Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety. Gastrointestinal Endoscopy, 71(1), 121-7. https://doi.org/10.1016/j.gie.2009.06.034
Mehdizadeh S, et al. Capsule Endoscopy in Patients With Crohn's Disease: Diagnostic Yield and Safety. Gastrointest Endosc. 2010;71(1):121-7. PubMed PMID: 19863957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety. AU - Mehdizadeh,Shahab, AU - Chen,Gary C, AU - Barkodar,Linda, AU - Enayati,Pedram J, AU - Pirouz,Shahriar, AU - Yadegari,Michael, AU - Ippoliti,Andrew, AU - Vasiliauskas,Eric A, AU - Lo,Simon K, AU - Papadakis,Konstantinos Antonios, Y1 - 2009/10/27/ PY - 2008/03/19/received PY - 2009/06/23/accepted PY - 2009/10/30/entrez PY - 2009/10/30/pubmed PY - 2010/4/28/medline SP - 121 EP - 7 JF - Gastrointestinal endoscopy JO - Gastrointest Endosc VL - 71 IS - 1 N2 - 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. DESIGN AND SETTING: Retrospective review of CE procedures performed in patients with CD between 2001 and 2005 in a tertiary care center. PATIENTS: One hundred thirty-four patients with an established diagnosis of CD and symptoms suggestive of active disease. INTERVENTIONS: Swallowing the capsule. MAIN OUTCOME MEASUREMENTS: 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). LIMITATIONS: 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. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/19863957/Capsule_endoscopy_in_patients_with_Crohn's_disease:_diagnostic_yield_and_safety_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(09)02191-9 DB - PRIME DP - Unbound Medicine ER -