Small-bowel manifestations are common complications in Crohn's disease but can often be underestimated because of diagnostic limitations.
Double-balloon enteroscopy is a new endoscopic method that provides complete visualization and biopsy sampling of the small bowel with potential implications for diagnosis and therapy.
|Double-balloon enteroscopy revealed pathology in 50%/td>|
|Scandinavian Journal of Gastroenterology|
Dr Julia Seiderer and colleagues from Germany compared the diagnostic yield of double-balloon enteroscopy and magnetic resonance enteroclysis in 10 patients suspected of having small-bowel Crohn's disease.
In all patients a double-balloon enteroscopy of the small bowel was performed.
The endoscopist was unaware of the radiological findings.
Evaluation criteria included the presence of pathology, localization, degree, and extension of affection according to predefined morphologic criteria.
The research team took samples for histopathological investigation in all patients with abnormal mucosa.
The researchers found that in 50% of the patients with suspected small-bowel Crohn's disease, double-balloon enteroscopy revealed pathological results.
In 4 patients, Crohn's disease was verified histologically.
The team noted that a new diagnosis had to be established in 1 patient diagnosed for malignant lymphoma.
The researchers reported that the medical management had to change in 5 patients.
In 2 patients, both double-balloon enteroscopy and magnetic resonance enteroclysis showed no pathological results.
In 3 patients, superficial lesions were identified by magnetic resonance enteroclysis, whereas double-balloon enteroscopy was normal.
Dr Seiderer's team concluded, "In selected patients with suspected small-bowel lesions, double-balloon enteroscopy is a promising tool in the diagnostic work-up and provides the advantage of biopsy sampling."
"In contrast, non-invasive magnetic resonance enteroclysis delivers excellent information about extraluminal pathology associated with Crohn's disease."
"Both magnetic resonance enteroclysis and double-balloon enteroscopy have the potential to become diagnostic standards that complement each other in patients with suspected complex small-bowel Crohn's disease."