Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK.
Eur J Gastroenterol Hepatol. 2013 Jun;25(6):706-13. doi: 10.1097/MEG.0b013e32835ddb85.
Although small bowel capsule endoscopy (SBCE) has developed an established role in Crohn's disease (CD), there is paucity of data on impact of SBCE on subsequent management. We investigated the clinical utility of SBCE in patients with suspected and established CD and inflammatory bowel disease unclassified (IBDU).
Patients referred routinely from 2003 to 2009 with a diagnosis of IBDU, suspected or established CD were identified retrospectively. Data were collected for indications and findings at SBCE with subsequent follow-up.
A total of 315 patients were identified. There were n=265 referred for suspected CD (of which n=37 had a prior diagnosis of IBDU) and n=50 with established CD. SBCE was suggestive of CD in 17% of the suspected CD group, 43% in the IBDU group and 66% in the established CD patients. In the suspected CD cohort, an eventual diagnosis of CD was made in 12% (n=31) after a mean follow-up of 15 months (range 1-84), resulting in a change of management in 90% (n=28/31). In patients with IBDU, the diagnosis of CD was made in 38% (n=14) after an average follow-up of 19 months (±2). In patients with established CD, management was altered in 73% of patients after SBCE.
There was a low diagnostic yield in patients referred with suspected CD although a diagnosis at SBCE was predictive of a clinical diagnosis in the majority after a mean follow-up of 15 months. A diagnosis of CD was more likely in the IBDU and established CD cohort. SBCE diagnoses changed management in the majority of patients.
虽然小肠胶囊内镜 (SBCE) 在克罗恩病 (CD) 中已确立了其作用，但关于 SBCE 对后续管理的影响的数据却很少。我们调查了 SBCE 在疑似和确诊 CD 以及未分类炎症性肠病 (IBDU) 患者中的临床应用。
回顾性地从 2003 年至 2009 年常规转诊的疑似 IBDU、疑似或确诊 CD 的患者中确定研究对象。收集 SBCE 的适应证和结果数据，并进行后续随访。
共确定了 315 例患者。其中 n=265 例因疑似 CD 而转诊（其中 n=37 例有 IBDU 既往诊断），n=50 例为确诊 CD。在疑似 CD 组中，SBCE 提示 CD 的比例为 17%，在 IBDU 组中为 43%，在确诊 CD 患者中为 66%。在疑似 CD 队列中，在平均随访 15 个月（范围 1-84）后，12%（n=31）的患者最终确诊为 CD，90%（n=28/31）的患者管理方式发生了改变。在 IBDU 患者中，平均随访 19 个月（±2）后，有 38%（n=14）的患者确诊为 CD。在确诊 CD 患者中，SBCE 后 73%的患者改变了治疗方案。
尽管 SBCE 诊断对大多数患者在平均 15 个月的随访后具有预测性，但在疑似 CD 患者中诊断率较低。在 IBDU 和确诊 CD 队列中，CD 的诊断可能性更大。SBCE 诊断改变了大多数患者的治疗方案。
