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News

Complementary methods for diagnosing Crohn's

Capsule endoscopy detects limited mucosal lesions, whereas magnetic resonance imaging identifies transmural Crohn's disease and extraluminal lesions, and may exclude strictures, reports December's Gut issue.

News image

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The diagnostic yield of capsule endoscopy compared with magnetic resonance imaging in small bowel Crohn's disease is not well established.

Dr Fleig and colleagues investigated capsule endoscopy, magnetic resonance imaging, and double contrast fluoroscopy.

The researchers assessed these methods in 52 consecutive patients with suspected small bowel Crohn's disease.

The team investigated if bowel obstruction could be excluded magnetic resonance imaging, fluoroscopy or capsule endoscopy.

In 25, Crohn's disease was newly suspected while the diagnosis had been previously established in 27.

The research team found that small bowel Crohn's disease was diagnosed in 79% of patients.

Capsule endoscopy detected small bowel Crohn's disease in 93% of cases
Gut

Capsule endoscopy was not accomplished in 14 patients due to bowel strictures.

Of the remaining 27 patients, the team noted that capsule endoscopy detected small bowel Crohn's disease in 93% of cases.

Magnetic resonance imaging detected small bowel Crohn's disease in 78% whereas fluoroscopy detected it in 33% of cases.

Capsule endoscopy was the only diagnostic tool in 4 patients and slightly more sensitive than magnetic resonance imaging.

The team observed that magnetic resonance imaging detected inflammatory conglomerates and enteric fistulae in 3 and 2 cases, respectively.

Dr Fleig's team concluded, “Capsule endoscopy and magnetic resonance imaging are complementary methods for diagnosing small bowel Crohn's disease.”

“Capsule endoscopy is capable of detecting limited mucosal lesions that may be missed by magnetic resonance imaging, but awareness of bowel obstruction is mandatory.”

“In contrast, magnetic resonance imaging is helpful in identifying transmural Crohn's disease and extraluminal lesions, and may exclude strictures.”

Gut 2005: 54: 1721-7
15 November 2005

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