Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety

Background: Capsule endoscopy (CE) is increasingly used in patients with suspected or known Crohn's disease (CD). Objective: To determine the diagnostic yield of CE and the distribution of (SB) lesions in symptom with known CD. Patients: One hundred thirty-four patients with an established diagnosis of CD and symptoms suggestive of active disease. Interventions. Swallowing the capsule. Main Outcome Measurements: Diagnostic yield of CE and distribution of SB lesions in patients with CD. Results: One hundred forty-six CE procedures were performed on 134 CD patients. Fifty-two (39%) of 134 patients had CE findings diagnostic of active CD (>3 ulceratins), and 17 (13%) had findings suggestive of active SB was 32% in the duodenum, 53% in the jejunum, 67% in thhe proximal ileum and 85% in the distal ileum. CE was comparable to ileoscopy in detecting ileal ulcerations (55% vs 48%) , but superior to SB follow-through in detecting CD lesions in the SB (incremental yield of 32%; 95% Cl, 9%-54%; p = 0.0017). Limitations: Retrospective study from a single center. Conclusions: CE indentified SB lesions in approximately half of sympotomatic CD patients. Large-scale prospective studies are needed to evaluate whtther positive CE findings may affect disease outcomes. (Gastrointest Endosc 2010;71:121-7.)