Background: Because it provides a direct view of superficial lesions in the small bowel, capsule endoscopy is a promising diagnostic tool for studying patients with suspected Crohn's disease undetected by conventional modalities.
Aim: To assess the role of capsule endoscopy in the diagnosis of patients with suspected Crohn's disease.
Patients and methods: Thirty-eight patients (16 males, mean age 46.2 years) with suspected Crohn's disease but negative at conventional imaging were examined using capsule endoscopy. They were divided into 2 groups: 12 patients with ongoing symptoms (Group 1), and 26 with ongoing symptoms and biochemical markers of inflammation (Group 2). Capsule endoscopy findings were classified as diagnostic (multiple erosions/ulcerations), suspicious (<or=3 erosions/ulcerations), non-specific and normal.
Results: Capsule endoscopy findings were diagnostic for Crohn's disease in 13 (34.2%) patients, suspicious in 2 (5.3%), non-specific in 4 (10.5%) and normal in 19 (50%), with an overall detection rate of 39.5%. The yield of positive findings was 8.3% in Group 1 and 46.2% in Group 2 (p=0.022). Capsule endoscopy findings prompted specific measures or patient management changes in 39.5% of patients.
Conclusions: Capsule endoscopy has a high diagnostic yield in patients with suspected Crohn's disease and both clinical and biochemical markers of inflammation.