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Background: The diagnosis of small- bowel Crohn’ s disease sometimes is dif ficult and may be missed by conventional imaging studies. Capsule endoscopy migh t identify small- bowel disease undetected by other investigations. Methods: Pa tients with or without known Crohn’ s disease who were suspected to have small - bowel Crohn’ s disease were prospectively evaluated with push enteroscopy, e nteroclysis, and capsule endoscopy. Each examiner was blinded to results of othe r investigations. Referring doctors were required to complete questionnaires bef ore and after the investigations. Results: Twenty- two patients were known to h ave Crohn’ s disease (Group 1), and 21 were suspected to have small- bowel Cro hn’ s disease (Group 2). In Group 1, capsule endoscopy detected more erosions t han the other two investigations (p< 0.001). In Group 2, a new diagnosis of Croh n’ s disease was made in two patients, but there was no significant difference in yield compared with the other two investigations. Referring physicians rated the usefulness of capsule endoscopy a s 4.4 on a scale of 5. Capsule endoscopy changed management for 30 patients (70 % ). Conclusions: Capsule endoscopy has a higher yield than push enteroscopy an d enteroclysis in patients with known Crohn’ s disease when small- bowel mucos al disease is suspected, and this leads to a change in management in the majorit y of these patients.
Background: The diagnosis of small-bowel Crohn’s disease is is dificult and may be missed by conventional imaging studies. Capsule endoscopy migh t identify small-bowel disease undetected by other investigations. Methods: Pa tients with or without known Crohn’s disease who were suspected to have small - bowel Crohn’s disease were prospectively evaluated with push enteroscopy, e nteroclysis, and capsule endoscopy. Each examiner was blinded to results of othe r investigations. For patients who were required to complete questionnaires bef ore and after the investigations. Results: Twenty-two patients were known to h ave Crohn’s disease (Group 1), and 21 were suspected to have small-bowel Cro hn ’s disease (Group 2). In Group 1, capsule endoscopy detected more erosions tnn the other two investigations (p <0.001). In Group 2, a new diagnosis of Croh n ’s disease was made in two patients, but there was no significant difference in yield compared with the other two investi gations. Referring physicians rated the usefulness of capsule endoscopy as 4.4 on a scale of 5. Capsule endoscopy changed management for 30 patients (70%). Conclusions: Capsule endoscopy has a higher yield than push enteroscopy an d enteroclysis in patients with known Crohn ’ s disease when small- bowel mucos al disease is suspected, and this leads to a change in management in the majorit y of these patients.