Fidder Herma H, Nadler Moshe, Lahat Adi, Lahav Maor, Bardan Eitan, Avidan Benjamin, Bar-Meir Simon
Department of Gastroenterology, Sackler School of Medicine, Chaim Sheba Medical Center, Tel Aviv University, Israel.
J Clin Gastroenterol. 2007 Apr;41(4):384-7. doi: 10.1097/01.mcg.0000225621.02094.8a.
Video capsule endoscopy (VCE) enables visualization of the entire small bowel and can identify lesions that may go undetected by conventional endoscopy and radiography. In this study, we assessed whether patient's selection based on symptoms may increase the yield of VCE in the diagnosis of Crohn's disease (CD).
Findings of 125 consecutive patients referred for VCE in whom CD may be suspected, were analyzed. Indications for VCE included iron-deficiency anemia, abdominal pain, diarrhea, or a combination of symptoms. Capsule endoscopy (CE) results were defined positive if 4 or more obvious clear ulcers, erosions, or a region with clear exudate and mucosal hyperemia and edema were identified.
One hundred twelve patients were included in the final analysis. Mean age of patients was 44+/-22 years and median follow-up 36+/-15 months. Findings on CE were considered compatible with a diagnosis of CD in 7 patients (6%). In general, CE yielded a diagnosis of CD in a very small portion of the patients (0% to 4%), except in patients undergoing the test for a combination of abdominal pain and diarrhea. In this group, findings suggestive of inflammatory bowel disease were encountered in one-third of the patients (P=0.002).
The greatest yield of CE in diagnosing CD is achieved in young patients who present with symptoms of abdominal pain plus diarrhea.
视频胶囊内镜检查（VCE）能够观察整个小肠，并可发现传统内镜检查和放射检查可能遗漏的病变。在本研究中，我们评估了基于症状选择患者是否可提高VCE对克罗恩病（CD）的诊断率。
分析了连续125例疑似患有CD而接受VCE检查患者的检查结果。VCE的适应证包括缺铁性贫血、腹痛、腹泻或多种症状并存。如果发现4个或更多明显的清晰溃疡、糜烂，或有清晰渗出物及黏膜充血水肿的区域，则胶囊内镜检查（CE）结果定义为阳性。
112例患者纳入最终分析。患者平均年龄为44±22岁，中位随访时间为36±15个月。7例（6%）患者的CE检查结果被认为符合CD诊断。总体而言，CE仅在极少部分患者（0%至4%）中诊断出CD，但腹痛和腹泻并存的患者除外。在这组患者中，三分之一的患者发现有提示炎症性肠病的表现（P = 0.002）。
CE诊断CD的最大诊断率出现在有腹痛加腹泻症状的年轻患者中。
