Please use this identifier to cite or link to this item: http://hdl.handle.net/1822/51536

TitleEssential role of small bowel capsule endoscopy in reclassification of colonic inflammatory bowel disease type unclassified
Author(s)Monteiro, Sara
Castro, Francisca Dias de
Carvalho, Pedro Boal
Rosa, Bruno
Moreira, Maria João
Pinho, Rolando
Saraiva, Miguel Mascarenhas
Cotter, José Almeida Berkeley
KeywordsInflammatory bowel disease
Inflammatory bowel disease type unclassified
Capsule endoscopy
Crohn's disease
Lewis score
Reclassification
Issue date2-Jan-2017
PublisherBaishideng Publishing Group
JournalWorld Journal of Gastrointestinal Endoscopy
CitationMonteiro, S., de Castro, F. D., Carvalho, P. B., Rosa, B., Moreira, M. J., Pinho, R., ... & Cotter, J. (2017). Essential role of small bowel capsule endoscopy in reclassification of colonic inflammatory bowel disease type unclassified. World journal of gastrointestinal endoscopy, 9(1), 34.
Abstract(s)AIM To evaluate the role of small bowel capsule endoscopy (SBCE) on the reclassification of colonic inflammatory bowel disease type unclassified (IBDU). METHODS We performed a multicenter, retrospective study including patients with IBDU undergoing SBCE, between 2002 and 2014. SBCE studies were reviewed and the inflammatory activity was evaluated by determining the Lewis score (LS). Inflammatory activity was considered significant and consistent with Crohn's disease (CD) when the LS >= 135. The definitive diagnosis during follow-up (minimum 12 mo following SBCE) was based on the combination of clinical, analytical, imaging, endoscopic and histological elements. RESULTS Thirty-six patients were included, 21 females (58%) with mean age at diagnosis of 33 +/- 13 (15-64) years. The mean follow-up time after the SBCE was 52 +/- 41 (12-156) mo. The SBCE revealed findings consistent with significant inflammatory activity in the small bowel (LS >= 135) in 9 patients (25%); in all of them the diagnosis of CD was confirmed during follow-up. In 27 patients (75%), the SBCE revealed no significant inflammatory activity (LS < 135); among these patients, the diagnosis of Ulcerative Colitis (UC) was established in 16 cases (59.3%), CD in 1 case (3.7%) and 10 patients (37%) maintained a diagnosis of IBDU during follow-up. A LS >= 135 at SBCE had a sensitivity = 90%, specificity = 100%, positive predictive value = 100% and negative predictive value = 94% for the diagnosis of CD. CONCLUSION SBCE proved to be fundamental in the reclassification of patients with IBDU. Absence of significant inflammatory activity in the small intestine allowed exclusion of CD in 94% of cases.
TypeArticle
URIhttp://hdl.handle.net/1822/51536
DOI10.4253/wjge.v9.i1.34
ISSN1948-5190
Publisher versionhttps://www.wjgnet.com/1948-5190/full/v9/i1/34.htm
Peer-Reviewedyes
AccessOpen access
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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