But how many misunderstood Crohn’s disease are revealed “by chance” using Capsule Endoscopy in Chronic Recurrent OGIB? Experience of a Single Italian Center and long term follow-up

R. Urgesi, R. Cianci, C. Marmo, G. Costamagna, M.E. Riccioni

Department of Internal Medicine, Ospedale Belcolle, Viterbo, Italy. riurgesi@tin.it

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• Gastroenterology

OBJECTIVE: The role of capsule endoscopy (CE) in Crohn’s disease (CD) has expanded with greater understanding of the technology. The ability of CE to differentiate CD from other causes of inflammation has been questioned. Longitudinal studies are required to assess the long-term impact and significance of CE findings in suspected CD. The aim of this work is to verify in how many misunderstood cases of suspected Crohn’s Disease CE was able to identify precociously and “by chance” when it is performed for recurrent obscure GI bleeding (OGIB), to evaluate how many of them were later confirmed during a median 24 months follow-up. Moreover, we observed the role of the early diagnosis in changing the clinical management of these patients.

PATIENTS AND METHODS: A retrospective review was carried out on CE procedures performed for suspected OGIB. 1008 consecutive patients was enrolled and 492 included in the study. Previous investigations such as ileo-colonoscopy and/or previous small bowel imaging were documented. Only patients with at least 6 months of documented follow-up were included. A chart review was undertaken to record CE findings/correlate with subsequent diagnosis and outcome.

RESULTS: 94/492 (19.1%) patients positive for suspected CD were identified. Follow-up data were available 64/94 (68%). The mean follow-up was 24 months. There was a strong positive correlation between results of CE and subsequent clinical diagnosis. The suspected CD was confirmed in 100% (94/94) of follow-up patients.

CONCLUSIONS: CE appears able to identify lesions compatible with suspected Crohn’s disease otherwise unacknowledged with consequently change in treatment options for the patients.

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