Efthymiou A, Viazis N, Vlachogiannakos J et al. Eur J Gastroenterol Hepatol 2009;21:866–71.
In this investigation, wireless capsule endoscopy (WCE) was compared with double-contrast enteroclysis (EC) for the evaluation of patients who had previously been diagnosed with Crohn’s disease or who were suspected of having the disease. WCE was found to have a significantly greater diagnostic capacity than EC both in patients with known Crohn’s disease (p=0.035) and in those who were suspected of having the disease (p=0.039).
Crohn’s disease is characterized by a chronic inflammatory process that can affect any part of gastrointestinal tract. The small intestine is involved in 30–40% of cases. A diagnosis is reached according to clinical, biochemical, endoscopic, histological, and radiological findings. Upper endoscopy is able to evaluate up to the duodenum, while colonoscopy allows the distal ileal tract to be assessed. Double-contrast enteroclysis (EC) is a precious tool for evaluating the small bowel; however, it is ineffective in detecting superficial mucosal lesions. Cross-sectional techniques such as computed tomography and magnetic resonance imaging with EC improve the visualization of the intestinal lumen and detection of extraluminal diseases, but they are of limited availability and dependent on the expertise of the operator. In 2000, the development of wireless capsule endoscopy (WCE) opened a new chapter in small-bowel examination. It is a painless technique and can detect minimal mucosal abnormalities.