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Digestive Diseases and Sciences

, Volume 62, Issue 1, pp 180–187 | Cite as

Diagnostic Value of Small Bowel Capsule Endoscopy in Isolated Ileitis: A CAPENTRY Study

  • Hyun Seok Lee
  • Yun Jeong LimEmail author
  • Ki Nam Shim
  • Chang Mo Moon
  • Hyun Joo Song
  • Jin Oh Kim
  • Seong Ran Jeon
  • Dae Young Jung
  • Ji Hyun Kim
  • Kyeong Ok Kim
  • Bo-In Lee
  • The Korean Gut Image Study Group
Original Article

Abstract

Background

Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions, but studies regarding the diagnostic impact of CE on ileitis are rare.

Aims

We evaluated the diagnostic value of small bowel CE for isolated ileitis observed during ileocolonoscopy.

Methods

The CE results in 137 patients initially diagnosed with ileitis without colonic mucosal abnormalities on ileocolonoscopy at one of eight tertiary referral centers between October 2002 and June 2015 were retrospectively analyzed.

Results

Among the 137 patients with isolated ileitis observed on ileocolonoscopy, 117 (85.4%) revealed positive small bowel CE findings (85.4%). The rate of positive small bowel CE findings was 92.9% in cases of ileal aphthous ulcer or erosion, and 90.9% in cases of ileal ulcer. Among 117 positive CE cases, the most common final diagnosis by CE was Crohn’s disease (CD) (n = 44, 32%). No findings were identified in 20 (14.6%) of 137 cases. Ileal erosion/ulcer, rather than findings such as nodularity and erythema or elevated erythrocyte sedimentation rate (ESR) (>10 mm/h), was significant predictive factors for positive CE findings in multivariate analysis.

Conclusions

Small bowel CE showed a high diagnostic yield (85.4%) in symptomatic patients with isolated ileitis on ileocolonoscopy. Erosion or ulcer of the small bowel was a common finding on CE (66.4%), and approximately one-third of patients were diagnosed with CD. In patients with isolated ileitis on ileocolonoscopy, CE should be considered to evaluate small bowel lesions when the patient shows an elevated ESR or when the ileitis manifests as ileal ulcer or erosion rather than a nodular or erythematous lesion.

Keywords

Ileitis Capsule endoscopy Colonoscopy Ileoscopy 

Notes

Acknowledgements

No financial relationships with a commercial entity producing healthcare-related products and/or services relevant to this article are declared.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Hyun Seok Lee
    • 1
  • Yun Jeong Lim
    • 2
    Email author
  • Ki Nam Shim
    • 3
  • Chang Mo Moon
    • 3
  • Hyun Joo Song
    • 4
  • Jin Oh Kim
    • 5
  • Seong Ran Jeon
    • 5
  • Dae Young Jung
    • 6
  • Ji Hyun Kim
    • 7
  • Kyeong Ok Kim
    • 8
  • Bo-In Lee
    • 6
  • The Korean Gut Image Study Group
  1. 1.Department of Internal Medicine, Kyungpook National University Medical CenterKyungpook National University School of MedicineDaeguKorea
  2. 2.Department of Internal Medicine, Dongguk University Ilsan HospitalDongguk University College of MedicineGoyangKorea
  3. 3.Department of Internal MedicineEwha Womans University School of MedicineSeoulKorea
  4. 4.Department of Internal MedicineJeju National University College of MedicineJejuKorea
  5. 5.Department of Internal MedicineSoonchunhyang University College of MedicineSeoulKorea
  6. 6.Department of Internal Medicine, College of MedicineThe Catholic University of KoreaSeoulKorea
  7. 7.Department of Internal MedicineInje University College of MedicineBusanKorea
  8. 8.Department of Internal MedicineYeungnam University College of MedicineDaeguKorea

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