Prospective comparison of small bowel meal with pneumocolon versus ileo-colonoscopy for the diagnosis of ileal Crohn's disease

The American Journal of Gastroenterology
John K MarshallE J Irvine

Abstract

Both endoscopy and barium radiography are used routinely to diagnose terminal ileal (TI) Crohn's disease (CD). A prospective study was undertaken to compare ileoscopy with biopsy to small bowel meal with pneumocolon (SBMP) in patients with suspected TI CD. A cohort of outpatients investigated for diarrhea with features of TI disease underwent SBMP followed by colonoscopy with ileal intubation and biopsy within 21 days. All results were reported in a standardized, sequential format to assign SBMP TI diagnoses by the duty radiologist and by dual reading with consensus, ileoscopy by the attending endoscopist, and ileoscopy with biopsy by a blinded panel of endoscopists and pathologists. Reference standard TI diagnoses were determined by a consensus panel with full access to medical records. Among 120 subjects, the reference standard TI diagnosis was normal in 47 (39.1%), lymphoid nodular hyperplasia (LNH) in 24 (20.0%), CD in 48 (40.0%), and NSAID enteropathy in 1 (0.9%). Colonoscopy provided TI images and/or biopsies in 97 cases (80.8%), while SBMP provided TI images in 119 (99.1%). When ileoscopy with biopsy succeeded, its accuracy was similar to SBMP with dual reading (89.7%vs 89.9%, p = NS) but superior to SBMP if interpreted ...Continue Reading

References

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Citations

Jul 21, 2004·Journal of Endourology
Jun 22, 2010·Journal of Pediatric Gastroenterology and Nutrition·Matthew StenersonNeera Gupta
Feb 17, 2006·Gut·E F StangeUNKNOWN European Crohn's and Colitis Organisation
Nov 27, 2008·World Journal of Gastroenterology : WJG·Sandeep NijhawanRamesh-Roop Rai
Aug 24, 2018·Journal of Crohn's & Colitis·Andreas SturmUNKNOWN European Crohn’s and Colitis Organisation [ECCO] and the European Society of Gastrointestinal and Abdominal Radiology [ESGAR
Dec 3, 2010·Journal of Crohn's & Colitis·Gert Van AsscheUNKNOWN European Crohn's and Colitis Organisation (ECCO)
Apr 1, 2016·Frontline Gastroenterology·Tom L Kaye, Chris Wilkinson
Mar 30, 2018·Insights Into Imaging·Håkan Geijer, Mats Geijer
Dec 4, 2020·World Journal of Gastroenterology : WJG·Maryam AlkhatryJimmy K Limdi

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