Capsule endoscopy in diagnosis of small bowel Crohn's disease.

AIM To evaluate the effectiveness of wireless capsule endoscopy in patients with suspected Crohn's disease (CD) of the small bowel undetected by conventional modalities, and to determine the diagnostic yield of M2A Given Capsule. METHODS From May 2002 to April 2003, we prospectively examined 20 patients with suspected CD by capsule endoscopy. The patients had the following features: abdominal pain, weight loss, positive fecal occult blood test, iron deficiency anaemia, diarrhoea and fever. All the patients had normal results in small bowel series (SBS) and in upper and lower gastrointestinal endoscopy before they were examined. Mean duration of symptoms before diagnosis was 6.5 years. RESULTS Of the 20 patients, 13 (65%) were diagnosed as CD of the small bowel according to the findings of M2A Given Capsule. The findings detected by the capsule were mucosal erosions (2 patients), aphthas (5 patients), nodularity (1 patient), large ulcers (2 patients), and ulcerated stenosis (3 patients). The distribution of the lesions was mainly in the distal part of the small bowel, and the mild degree of lesions was 54%. CONCLUSION Wireless capsule endoscopy is effective in diagnosing patients with suspected CD undetected by conventional diagnostic methods. It can be used to detect early lesions in the small bowel of patients with CD.

[1]  B. Lewis,et al.  The history of enteroscopy. , 1999, Gastrointestinal endoscopy clinics of North America.

[2]  H. Fidder,et al.  Capsule Endoscopy for the Evaluation of Patients with Chronic Abdominal Pain , 2003, Endoscopy.

[3]  T. Ang,et al.  Clinical utility, safety and tolerability of capsule endoscopy in urban Southeast Asian population. , 2003, World Journal of Gastroenterology.

[4]  Paul Swain,et al.  Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: Results of a pilot study. , 2002, Gastrointestinal endoscopy.

[5]  P. Swain,et al.  Wireless capsule endoscopy. , 2002, The Israel Medical Association journal : IMAJ.

[6]  R. Seensalu.  The Sonde Examination , 1999 .

[7]  I. Bjarnason,et al.  Non-invasive investigation of inflammatory bowel disease. , 2001, World journal of gastroenterology.

[8]  G. Costamagna,et al.  A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. , 2002, Gastroenterology.

[9]  A. Gossum,et al.  A prospective, comparative study between push enteroscopy and wireless video capsule in patients with obscure digestive bleeding. , 2003, Gastroenterology.

[10]  A. Schreyer,et al.  New Diagnostic Avenues in Inflammatory Bowel Diseases , 2003, Digestive Diseases.

[11]  Zhi Zheng Ge,et al.  Clinical application of wireless capsule endoscopy , 2003 .

[12]  Zvi Fireman,et al.  Wireless capsule endoscopy. , 2002, The Israel Medical Association journal : IMAJ.

[13]  G. Iddan,et al.  Wireless capsule endoscopy , 2003, Gut.

[14]  C. Swain,et al.  The Wireless Capsule: New Light in the Darkness , 2002, Digestive Diseases.

[15]  P. Swain,et al.  Wireless-capsule diagnostic endoscopy for recurrent small-bowel bleeding. , 2001, The New England journal of medicine.

[16]  Simon Bar-Meir,et al.  Wireless capsule endoscopy--pros and cons. , 2002, The Israel Medical Association journal : IMAJ.

[17]  Zvi Fireman,et al.  Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology. , 2002 .

[18]  P. Swain,et al.  A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions. , 2000, Gastroenterology.

[19]  A. May,et al.  The First Prospective Controlled Trial Comparing Wireless Capsule Endoscopy with Push Enteroscopy in Chronic Gastrointestinal Bleeding , 2002, Endoscopy.

[20]  C. Swain,et al.  The role of enteroscopy in clinical practice. , 1999, Gastrointestinal endoscopy clinics of North America.

[21]  G. J. Gay,et al.  Enteroscopy in small intestinal inflammatory diseases. , 1999, Gastrointestinal endoscopy clinics of North America.

[22]  Douglas K Rex,et al.  Wireless Capsule Endoscopy Detects Small Bowel Ulcers in Patients With Normal Results From State of the Art Enteroclysis , 2003, American Journal of Gastroenterology.