Wireless capsule endoscopy (WCE) offers endoscopic access to the small bowel and may therefore change diagnostic and therapeutic strategies in small bowel diseases.
Dr Voderholzer and colleagues from Berlin, Germany undertook a study in order to validate the gain in information and therapeutic impact of WCE in patients with Crohn’s disease.
The investigators oversaw computed tomography (CT) enteroclysis, and if stenoses <10 mm were excluded, WCE, in a total of 56 consecutive patients with Crohn’s disease.
The researchers found that 15 patients could not have WCE performed due to strictures detected by CT enteroclysis.
| Both methods were not significantly different in the detection of lesions in the terminal/neoterminal ileum|
From the other 41 patients, the researchers found jejunal or ileal lesions in 25 patients by WCE compared with 12 by CT enteroclysis.
The researchers noted that this gain in information was mainly due to detection of small mucosal lesions such as villous denudation, aphthoid ulcerations, or erosions.
Both methods were not significantly different in the detection of lesions in the terminal/neoterminal ileum (WCE 24 patients, CT enteroclysis 20 patients).
The investigators changed the therapy due to WCE findings in 10 patients.
The researchers noted that consecutively, all of them improved clinically.
Dr Voderholzer concluded, "Capsule endoscopy improves the diagnosis of small bowel Crohn’s disease."
"This may have significant therapeutic impact."