Intest Res.  2017 Oct;15(4):467-474. 10.5217/ir.2017.15.4.467.

Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease

• Kim Y
• Jeon SR
• Choi SM
• Kim HG
• Lee TH
• Cho JH
• Jung Y
• Kim WJ
• Ko BM
• Kim JO
• Lee JS
• Lee MS

• KMID: 2396396
• DOI: http://doi.org/10.5217/ir.2017.15.4.467

Abstract

BACKGROUND/AIMS
Although the role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients.
METHODS
Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD) and 14 cases of established CD (eCD).
RESULTS
In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%). Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%). In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%), non-steroidal anti-inflammatory drug-induced enteropathy (5.3%), and other enteritis (17.5%). Only 11.5% of patients with eCD (14/122) underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings.
CONCLUSIONS
In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.

Keyword

Crohn disease; Capsule endoscopy; Indication; Therapeutic plan

MeSH Terms

Capsule Endoscopy*
Crohn Disease*
Diagnosis
Enteritis
Humans
Korea
Medical Records
Retrospective Studies

Figure

• 

  Fig. 1 Endoscopic findings of small bowel diseases. Capsule endoscopy (CE) images of CD show (A) ulcerations with luminal stricture, (B) a longitudinal ulcer scar (arrow), (C) luminal stricture with pseudopolyps and red spots (arrows), and (D) nodular lymphoid hyperplasia. CE images of intestinal tuberculosis and NSAID-induced enteropathy reveal (E) cicatricial change and (F) diaphragm-like strictures, respectively.

• 

  Fig. 2 Final diagnosis in suspected CD group. TB, tuberculosis; DY, diagnostic yield.

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