Is it a prime time for small-bowel colon video capsule endoscopy to cover both sides of the ileocecal valve in Crohn’s disease?

2017 ◽  
Vol 85 (1) ◽  
pp. 206-209 ◽  
Author(s):  
Bo Shen
2017 ◽  
Vol 47 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Surinder Singh Rana ◽  
Vishal Sharma ◽  
Ravi Sharma ◽  
Ritambhra Nada ◽  
Rajesh Gupta ◽  
...  

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.


2019 ◽  
Author(s):  
Zihan Huang ◽  
Xiang Liu ◽  
Fei Yang ◽  
Guoxin Wang ◽  
Nan Ge ◽  
...  

Abstract Background Due to the development of double-balloon enteroscopy and video capsule endoscopy, direct visualization of the entire small intestinal mucosa has been achieved. Compared with video capsule endoscopy, double-balloon enteroscopy has the advantages of biopsy samples and endoscopic treatment. The aim of this research was to explore the value of double-balloon enteroscopy for isolated small bowel Crohn’s disease. Methods This study included patients with suspected isolated small bowel Crohn’s disease who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients with symptoms of chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic Crohn’s disease were excluded from this cohort. Patients with suspected isolated small bowel Crohn’s disease underwent double-balloon enteroscopy. Results With clear endoscopic images and histological support, 14 patients were diagnosed with isolated small bowel Crohn’s disease. Three patients who were diagnosed with small bowel Crohn’s disease by double-balloon enteroscopy showed improved morphological features of the small bowel when the double-balloon enteroscopy was reviewed after medical treatment. Conclusions The diagnosis of Crohn’s disease is usually based on the patient’s clinical history and related examinations. Double-balloon enteroscopy provides imaging support and histological support for the definitive diagnosis of Crohn’s disease and can be considered as a useful tool to evaluate the therapeutic efficacy in the future.


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