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Wireless capsule endoscopy and proximal small bowel lesions in Crohn’s disease

Author(s): Carmelina Petruzziello, Sara Onali, Emma Calabrese, Francesca Zorzi, Marta Ascolani, Giovanna Condino, Elisabetta Lolli, Paola Naccarato, Francesco Pallone, Livia Biancone

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 16;
Issue: 26;
Start page: 3299;
Date: 2010;
Original page

Keywords: Wireless capsule endoscopy | Crohn’s disease | Small bowel

AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn’s disease (CD).METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis.RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidal anti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2).CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum.
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