Leighton JA, Gralnek IM, Richner RE et al. World J Gastroenterol 2009;15:5685–92.
Using decision analytic modeling, these authors investigated the clinical and economic benefits of capsule endoscopy (CE) compared with ileo-colonoscopy and small-bowel follow-through (SBFT) for the evaluation of Crohn’s disease. Overall, CE was marginally less costly than the use of SBFT; however, other factors such as possible intestinal retention of the capsule should also be considered when deciding upon the assessmenttechnique used.
Crohn’s disease is characterized by a chronic inflammatory process that can affect any part of gastrointestinal tract, although the small bowel is involved in >70% of cases. The difficult diagnosis is the result of clinical, biochemical, endoscopic, histological, and radiological findings. Upper endoscopy is able to evaluate the second part of the duodenum; however, colonoscopy is required for assessment of distal ileal tract. Small-bowel follow-through (SBFT) is a valuable tool for evaluating the small bowel, but it is ineffective in detecting superficial mucosal lesions. Cross-sectional techniques such as computed tomography and magnetic resonance imaging with enteroclysis improve the visualization of the intestinal lumen and detection of extraluminal diseases; however, they are of limited availability and substantial expertise of the radiologist is a necessity.