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Small-bowel capsule endoscopy in patients with suspected Crohn's disease-diagnostic value and complications

机译:小肠胶囊内镜检查对可疑克罗恩病的诊断价值和并发症

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摘要

Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.
机译:背景。这项工作的目的是评估胶囊肠镜检查在诊断可疑克罗恩病(CD)患者中的价值。方法。这是在单个三级护理中心进行的一项回顾性研究,涉及接受胶囊肠镜检查的可疑CD患者。在前三十天或随访期少于六个月内服用非甾体类抗炎药的患者被排除在外。结果。包括七十八名患者。内窥镜检查结果包括粘膜破裂占50%,溃疡性狭窄占5%,绒毛萎缩占4%。 CD的诊断在31例患者中得到确定。内窥镜检查结果的敏感性,特异性,阳性和阴性预测值分别为93%,80%,77%和94%。胶囊保留发生在四名患者(5%)中。在炎症标记阳性的患者中,溃疡性狭窄的发生率明显更高。回肠镜检查阴性的患者对胶囊肠镜的诊断率为56%,诊断灵敏度为93%。结论。小肠胶囊内镜检查是评估可疑CD患者的一种安全有效的技术。具有阳性炎症标记物的患者胶囊保留更为频繁。回肠镜检查阴性且怀疑CD的患者应接受胶囊肠镜检查。

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