Cattedra di Gastroenterologia, Università degli Studi di Roma "Tor Vergata", Rome, Italy.
J Crohns Colitis. 2011 Apr;5(2):139-47. doi: 10.1016/j.crohns.2010.12.004. Epub 2011 Jan 14.
BACKGROUND & AIMS: The diagnostic role of Small Bowel Capsule Endoscopy (SBCE) in Crohn's Disease (CD) is under investigation. In a prospective study we investigated the diagnostic role of SBCE in patients with symptoms highly compatible with CD and undefined diagnosis after conventional techniques.
From September 2005 to May 2009, all patients with clinically suspected CD and not conclusive diagnosis after Ileocolonoscopy (IC), Small Bowel Follow Through (SBFT) and Small Intestine Contrast Ultrasonography (SICUS) were enrolled. Findings compatible with CD included: bowel wall thickness (BWT) >3mm (for SICUS), ulcers, stenosis/strictures, fistulae (for SICUS, SBFT); >5 aphtoid ulcers, deep ulcers and/or strictures (for SBCE).
Conventional techniques did not lead to a conclusive diagnosis in 30 patients (19 F, median age 31 years, range 8-57), showing chronic diarrhoea (n=27), abdominal pain (n=23), weight loss (n=5), fever (n=5), Iron Deficiency Anaemia (IDA)(n=5) and/or perianal disease (n=4). Findings compatible but not diagnostic for small bowel CD were detected in 19 (63%) by IC in 12 (40%) by SICUS and in 15 (50%) by SBFT. SBCE showed ileal lesions in 15 (50%) patients, including findings compatible with CD in 12 (40%). SBCE retention requiring surgery was observed in 1 patient. A significant concordance was observed between SBCE and IC k=0.33 C(k)=[0.25;0.42], but not between SBCE and SICUS k=0.13 IC(k)=[0.045;0.22] and between SBCE and SBFT k=0 IC(k)=[-0.089;0.089].
SBCE may detect lesions compatible with small bowel CD in almost one third of patients with symptoms highly compatible with CD and not conclusive diagnosis by using conventional techniques.
小肠胶囊内镜（SBCE）在克罗恩病（CD）中的诊断作用正在研究中。在一项前瞻性研究中，我们调查了 SBCE 在症状高度符合 CD 且常规技术检查后诊断不明确的患者中的诊断作用。
从 2005 年 9 月至 2009 年 5 月，所有具有临床疑似 CD 且在回结肠镜检查（IC）、小肠随检（SBFT）和小肠对比超声检查（SICUS）后诊断不明确的患者均被纳入本研究。符合 CD 的发现包括：肠壁厚度（BWT）>3mm（用于 SICUS）、溃疡、狭窄/梗阻、瘘管（用于 SICUS、SBFT）；>5 个口疮样溃疡、深溃疡和/或狭窄（用于 SBCE）。
常规技术在 30 例患者（19 例女性，中位年龄 31 岁，范围 8-57 岁）中未得出明确诊断，这些患者表现为慢性腹泻（n=27）、腹痛（n=23）、体重减轻（n=5）、发热（n=5）、缺铁性贫血（IDA）（n=5）和/或肛周疾病（n=4）。19 例（63%）患者通过 IC、12 例（40%）患者通过 SICUS 和 15 例（50%）患者通过 SBFT 发现了符合但不具有诊断意义的小肠 CD 表现。15 例（50%）患者的 SBCE 显示回肠病变，其中 12 例（40%）患者的发现符合 CD。1 例患者的 SBCE 出现内镜下保留需要手术。SBCE 与 IC 的一致性显著相关（k=0.33，C（k）=[0.25；0.42]），但 SBCE 与 SICUS 的一致性不显著（k=0.13，C（k）=[0.045；0.22]），SBCE 与 SBFT 的一致性也不显著（k=0，C（k）=[-0.089；0.089]）。
在症状高度符合 CD 且常规技术检查后诊断不明确的患者中，SBCE 可检测到符合小肠 CD 的病变，约占三分之一。
