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 20 January 2018

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News

Wireless capsule video endoscopy in suspected Crohn's disease

Capsule video endoscopy is superior to barium follow-through and entero-CT in diagnosing Crohn's disease, find researchers in the April issue of the European Journal of Gastroenterology and Hepatology.

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Wireless M2A capsule video endoscopy (CVE) is superior to barium follow-through and enteroscopy in diagnosing patients with occult blood loss and iron-deficiency anemia.

In this study, researchers from Israel compared CVE to barium follow-through and entero-computerized tomography (CT) in the diagnosis of patients with suspected Crohn's disease.

The team conducted their study in a single academic hospital.

The researchers recruited 20 patients with recurrent abdominal pain and/or weight loss, or chronic diarrhea.

Patients underwent barium follow-through as their initial examination, followed by CVE and entero-CT.

The radiologist who performed the barium follow-through and entero-CT was blinded to the results of the CVE.

In addition, a blinded reader, unaware of the study objective, diagnosed the results of the CVE.

Capsule video endoscopy confirmed suspected Crohn's disease in 6 of the 20 patients.
European Journal of Gastroenterology and Hepatology

In cases where there was a discrepancy between examinations, colonoscopy and ileoscopy were performed.

The team recorded the diagnosis and extent of disease for each patient.

Of the 20 patients, 95% had abdominal pain, 75% had diarrhea, and 65% had weight loss.

Only 13 patients underwent entero-CT.

The team found that CVE confirmed the diagnosis of Crohn's disease suspected by alternative methods in 6 of the 20 patients.

In addition, CVE diagnosed Crohn's disease in 6 patients who had normal barium follow-through or entero-CT.

The team also found that CVE ruled out a diagnosis of Crohn's disease, suspected by other modalities, in 3 patients.

CVE extended the involvement of Crohn's disease in 3 of the patients, and established new diagnoses in 2.

Overall, the team found that CVE established new diagnoses, confirmed existing diagnoses, enlarged the extent of the disease, and ruled out the suspicion of Crohn's disease in 70% of the patients.

Barium follow-through established diagnoses, measured the extent of the disease, and ruled out the suspicion of Crohn's disease in 37% of the patients.

Furthermore, the capsule detected all of the lesions diagnosed by barium follow-through and entero-CT.

In addition, CVE detected lesions that were not detected by other modalities in 47% of cases. It also ruled out lesions that were detected by other modalities in 16% of cases.

Dr Rami Eliakim’s team concluded, “CVE is a superior and more sensitive procedure than barium follow-through and entero-CT in establishing the diagnosis and estimating the extent of Crohn's disease”.

Eur J Gastroenterol Hepatol 2003; 15(4): 363-7
26 March 2003

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