Little is known about the accuracy of capsule endoscopy in evaluation of small-bowel Crohn's disease.
Symptomatic eligible patients had ileocolonoscopy and biopsies from the terminal ileum, followed by small-bowel radiologic studies before capsule endoscopy.
Dr Elena Dubcenco and colleagues compared endoscopic, radiologic, capsule endoscopy, and histologic findings.
Histology, terminal ileum biopsy specimens or a tissue sample after small-bowel resection served as a criterion standard.
|Capsule endoscopy had a positive predictive value of 100%|
The investigators enrolled 54 patients, and excluded 15 of the 54 patients from data analysis.
Data were analyzed for 39 patients.
All patients had histologic evaluation of the small bowel.
The investigative team made a final diagnosis of active small-intestine Crohn's disease in 74 % patients.
When calculated, capsule endoscopy yielded a sensitivity and a specificity of 90% and 100%, respectively.
The team noted that capsule endoscopy had a positive predictive value and a negative predictive value of 100% and 77%, respectively.
In addition, the investigators found that small-bowel series had a positive predictive value of 100% and a negative value of 32%.
Small-bowel series had a sensitivity of 28% and a specificity of 100%.
Dr Dubcenco's concluded, “Capsule endoscopy is more accurate in detecting small-bowel inflammatory changes suggestive of Crohn's disease than conventional studies.”
“Capsule endoscopy, combined with ileocolonoscopy, may be proposed as a first-line investigation of the small intestine in cases of uncomplicated known or suspected Crohn's disease.”