Intestinal Research

Original Articles

Clinical characteristics and long-term disease course in patients with Crohn’s disease as diagnosed by video capsule endoscopy: a multicenter retrospective matched case-control study: June Hwa Bae, Su Hyun Park, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Kyeong Ok Kim, Byung Ik Jang, Mi Rae Lee, Eun Soo Kim, Sang Hyoung Park; Received April 18, 2024 Accepted July 15, 2024 Published online August 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00056 [Epub ahead of print]

Abstract PDF PubReader ePub: Background/Aims
Video capsule endoscopy is rarely used to diagnose Crohn’s disease in patients with negative ileocolonoscopy or cross-sectional image findings. We evaluated clinical characteristics and long-term outcomes of these rare cases.
Methods
This multicenter study included patients with Crohn’s disease from 3 tertiary hospitals from January 2007 to October 2022. Patients with normal findings on ileocolonoscopy and computed tomography (CT)/magnetic resonance (MR) enterography but had ulcerations at the small bowel detected by video capsule endoscopy were included. The controls were patients with abnormal findings on endoscopy or CT/MR enterography. Controls were case-matched in a ratio of 3:1 for sex, calendar year of diagnosis, and age at diagnosis.
Results
Among 3,752 patients, 24 (0.6%) were diagnosed with Crohn’s disease using video capsule endoscopy findings. The disease location (P< 0.001) and behavior at diagnosis (P= 0.013) of the cases significantly differed from that of controls. The perianal fistula modifier (25.0% vs. 33.3%, P= 0.446) did not differ significantly between the 2 groups. Initial disease activity and C-reactive protein and fecal calprotectin levels were significantly lower in cases versus controls. The median Lewis score was 838 (interquartile range, 393–1,803). Over 10 years of follow-up, the cases showed significantly lower cumulative risk of complicated behavior, biologics use, Crohn’s disease-related hospitalization, and surgeries (log-rank test P< 0.05).
Conclusions
Patients with Crohn’s disease whose lesions were observed only by video capsule endoscopy were rare, and exhibit different clinical characteristics and a more favorable long-term disease course compared to those who were conventionally diagnosed.

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IBD

Efficacy of serum leucine-rich alpha-2 glycoprotein in predicting findings of Crohn’s disease small bowel lesion in capsule endoscopy: Teppei Omori, Miki Koroku, Shun Murasugi, Ayumi Ito, Maria Yonezawa, Shinichi Nakamura, Katsutoshi Tokushige; Intest Res 2024;22(4):464-472. Published online May 7, 2024; DOI: https://doi.org/10.5217/ir.2023.00139

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Small bowel capsule endoscopy (SBCE) is an evaluation method for small bowel (SB) lesions in Crohn’s disease (CD). However, the relationship between SBCE findings and the serological biomarker leucine-rich alpha-2 glycoprotein (LRG) remains unclear. We aimed to establish appropriate cutoff values of LRG to predict the presence of SB lesions in CD through SBCE.
Methods
Patients with CD with SB lesions who had undergone SBCE and LRG measurements 1 month before and after the SBCE were included. The LRG values for ulcers ≥0.5 cm and other inflammatory lesions noted in SBCE were determined using the Youden Index, and the sensitivity and specificity were calculated. Additionally, the correlation between the SBCE scores (CD Activity in Capsule Endoscopy) and LRG values was evaluated.
Results
Forty patients without active colorectal lesions were included in the study. When the cutoff value of LRG for SB ulcers ≥ 0.5 cm was set at 14 μg/mL, the sensitivity was 92.3%, specificity was 81.5%, positive predictive value (PPV) was 70.6%, and negative predictive value (NPV) was 95.7%. In contrast, an LRG cutoff value of 12 μg/mL without inflammatory findings had a sensitivity of 91.7%, specificity of 82.1%, PPV of 68.8%, and NPV of 95.8%. CD Activity in Capsule Endoscopy correlated well with LRG values (Spearman’s rank correlation coefficient ρ = 0.681, P< 0.001).
Conclusions
An LRG cutoff value of 14 μg/mL may be useful in predicting the presence of SB ulcers ≥ 0.5 cm, and an LRG cutoff value of 12 μg/mL may be useful in predicting the absence of SB inflammatory findings.

Citations

Citations to this article as recorded by

Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease
Masashi Ohno, Atsushi Nishida, Akinori Otsuki, Yoshihiro Yokota, Takayuki Imai, Shigeki Bamba, Osamu Inatomi
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease
Jun Owada, Kunihiko Oguro, Tomonori Yano, Yusuke Ono, Takuma Kobayashi, Shoko Miyahara, Hirotsugu Sakamoto, Hironori Yamamoto
DEN Open.2025;[Epub] CrossRef

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2 Crossref

Review

Inflammatory bowel diseases

Capsule endoscopy in inflammatory bowel disease: when and how: Ida Hilmi, Taku Kobayashi; Intest Res 2020;18(3):265-274. Published online July 7, 2020; DOI: https://doi.org/10.5217/ir.2019.09165

Abstract PDF PubReader ePub

Capsule endoscopy (CE) is emerging as an important investigation in inflammatory bowel disease (IBD); common types include the standard small bowel CE and colon CE. More recently, the pan-enteric CE was developed to assess the large and small bowel in patients with Crohn’s disease (CD). Emerging indications include noninvasive assessment for mucosal healing (both in the small bowel and the colon) and detection of postoperative recurrence in patients with CD. Given the increasing adoption, several CE scoring systems have been specifically developed for IBD. The greatest concern with performing CE, particularly in CD, is capsule retention, but this can be overcome by performing cross-sectional imaging such as magnetic resonance enterography and using patency capsules before performing the procedure. The development of software for automated detection of mucosal abnormalities typically seen in IBD may further increase its adoption.

Citations

Citations to this article as recorded by

Endoscopy in Inflammatory Bowel Disease
Joëlle St-Pierre, David T. Rubin
Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 1. CrossRef
Evaluation of the safety, efficacy and feasibility of ‘at-home’ capsule endoscopy
Ioanna Parisi, Angelica Vania Hosea, Sandro Stoffel, Martin Nemec, Sohail Badat, Edward Seward, Aradhna Kaushal, Robert Kerrison, Christian Von Wagner
Frontline Gastroenterology.2024; 15(4): 273. CrossRef
Discordance Rate and Risk Factor of Other Diagnostic Modalities for Small Bowel Tumors Detected by Device-Assisted Enteroscopy: A Korean Association for the Study of Intestinal Disease (KASID) Multicenter Study
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Gut and Liver.2024; 18(4): 686. CrossRef
Paediatric gastrointestinal endoscopy in the Asian-Pacific region: Recent advances in diagnostic and therapeutic techniques
James Guoxian Huang, Pornthep Tanpowpong
World Journal of Gastroenterology.2023; 29(18): 2717. CrossRef
The role of video capsule endoscopy in the diagnosis of gastrointestinal diseases: experience of the Department of Diagnostic and Operative Endoscopy
A. A. Likutov, T. A. Vlasko, V. V. Veselov
Ambulatornaya khirurgiya = Ambulatory Surgery (Russia).2023; 20(2): 116. CrossRef
Radiology plus ileocolonoscopy versus radiology alone in Crohn’s disease: prognosis prediction and mutual agreement
Hye Kyung Hyun, Jongwook Yu, Eun Ae Kang, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
The Korean Journal of Internal Medicine.2022; 37(3): 567. CrossRef
Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study
Yuna Kim, Jae-Hyun Kim, Eun-Ae Kang, Soo-Jung Park, Jae-Jun Park, Jae-Hee Cheon, Tae-Il Kim, Jihye Park, Seong-Ran Jeon
Diagnostics.2022; 12(4): 954. CrossRef
Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn’s Disease: Manifestations and the Value of Assessing Disease Activity
Jia Li, Xuesong Zhao, Wen Su, Ruizhe Shen, Yuan Xiao, Xinqiong Wang, Xu Xu, Chundi Xu, Na Li, Yi Yu
Frontiers in Pharmacology.2022;[Epub] CrossRef
Clinical Outcomes between P1 and P0 Lesions for Obscure Gastrointestinal Bleeding with Negative Computed Tomography and Capsule Endoscopy
Young Kyu Cho, Heesu Park, Jung Rock Moon, Seong Ran Jeon, Hyun Gun Kim, Tae Hee Lee, Junseok Park, Jin-Oh Kim, Joon Seong Lee, Hyeon Jeong Goong, Bong Min Ko, Suyeon Park
Diagnostics.2021; 11(4): 657. CrossRef
Rediscovering histology: what is new in endoscopy for inflammatory bowel disease?
Virginia Solitano, Ferdinando D’Amico, Mariangela Allocca, Gionata Fiorino, Alessandra Zilli, Laura Loy, Daniela Gilardi, Simona Radice, Carmen Correale, Silvio Danese, Laurent Peyrin-Biroulet, Federica Furfaro
Therapeutic Advances in Gastroenterology.2021;[Epub] CrossRef
Diagnostic Accuracy of Fecal Calprotectin for the Detection of Small Bowel Crohn's Disease through Capsule Endoscopy: An Updated Meta-Analysis and Systematic Review
Eun Suk Jung, Sang Pyo Lee, Sea Hyub Kae, Jung Han Kim, Hyeong Su Kim, Hyun Joo Jang
Gut and Liver.2021; 15(5): 732. CrossRef
Capsule Endoscopy in Crohn’s Disease—From a Relative Contraindication to Habitual Monitoring Tool
Adi Lahat, Ido Veisman
Diagnostics.2021; 11(10): 1737. CrossRef
Addition of castor oil as a booster in colon capsule regimens significantly improves completion rates and polyp detection
Serhiy Semenov, Mohd Syafiq Ismail, Fintan O'Hara, Sandeep Sihag, Barbara Ryan, Anthony O'Connor, Sarah O'Donnell, Deirdre McNamara
World Journal of Gastrointestinal Pharmacology and Therapeutics.2021; 12(6): 103. CrossRef
Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
Diagnostics.2021; 11(11): 2123. CrossRef

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Case Report

Steroid-refractory extensive enteritis complicated by ulcerative colitis successfully treated with adalimumab: Shinji Okabayashi, Taku Kobayashi, Tomohisa Sujino, Ryo Ozaki, Satoko Umeda, Takahiko Toyonaga, Eiko Saito, Masaru Nakano, Maria Carla Tablante, Shojiroh Morinaga, Toshifumi Hibi; Intest Res 2017;15(4):535-539. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.535

Abstract PDF PubReader ePub

Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down. Computed tomography revealed marked thickening of the ileal wall, and capsule endoscopy and balloon-assisted enteroscopy found diffuse mucosal inflammation with ulcers in the ileum. On the contrary, the inflammation in the colon and rectum was improving. Since the response to the second steroid course was inadequate, treatment with adalimumab and 6-mercaptopurine was initiated and finally achieved clinical and endoscopic remission. The investigation of small intestinal lesions is necessary in patients with UC whose clinical deterioration cannot be explained by colonic lesions.

Citations

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A case of relapsed pan-colonic ulcerative colitis accompanied with gastroduodenal lesions immediately after COVID-19
Katsuya Endo, Tomonori Satoh, Yuki Yoshino, Shiho Kondo, Yoko Kawakami, Daisuke Fukushi, Atsuko Takasu, Takayuki Kogure, Morihisa Hirota, Kennichi Satoh
Clinical Journal of Gastroenterology.2025; 18(3): 399. CrossRef
Clinical Features and Therapeutic Outcomes of Post-colectomy Enteritis with Ulcerative Colitis
Yuki Horio, Motoi Uchino, Kazutoshi Hori, Kurando Kusunoki, Tomohiro Minagawa, Ryuichi Kuwahara, Kozo Kataoka, Naohito Beppu, Masataka Ikeda, Hiroki Ikeuchi
Journal of the Anus, Rectum and Colon.2021; 5(4): 405. CrossRef

8,639 View
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2 Crossref

Original Article

Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease: Yonghyun Kim, Seong Ran Jeon, Sang Myung Choi, Hyun Gun Kim, Tae Hee Lee, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joon Sung Lee, Moon Sung Lee; Intest Res 2017;15(4):467-474. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.467

Abstract PDF PubReader ePub

Background/Aims

Although the role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients.

Methods

Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD) and 14 cases of established CD (eCD).

Results

In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%). Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%). In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%), non-steroidal anti-inflammatory drug-induced enteropathy (5.3%), and other enteritis (17.5%). Only 11.5% of patients with eCD (14/122) underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings.

Conclusions

In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.

Citations

Citations to this article as recorded by

Video capsule endoscopy in inflammatory bowel disease
Kenji J.L. Limpias Kamiya, Naoki Hosoe, Yukie Hayashi, Takaaki Kawaguchi, Kaoru Takabayashi, Haruhiko Ogata, Takanori Kanai
DEN Open.2022;[Epub] CrossRef
Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study
Seong Ran Jeon, Jin-Oh Kim, Jeong-Sik Byeon, Dong-Hoon Yang, Bong Min Ko, Hyeon Jeong Goong, Hyun Joo Jang, Soo Jung Park, Eun Ran Kim, Sung Noh Hong, Jong Pil Im, Seong-Eun Kim, Ja Seol Koo, Chang Soo Eun, Dong Kyung Chang
Gut and Liver.2021; 15(3): 375. CrossRef
Capsule Endoscopy in Crohn’s Disease—From a Relative Contraindication to Habitual Monitoring Tool
Adi Lahat, Ido Veisman
Diagnostics.2021; 11(10): 1737. CrossRef
Use of small bowel capsule endoscopy in clinical practice: how has it performed?
Seong Ran Jeon
The Korean Journal of Internal Medicine.2020; 35(4): 854. CrossRef
Pursuing therapeutic success in Crohn’s disease: A matter of definition, tools and longterm outcomes
Loredana Goran, Monica State, Ana Maria Negreanu, Lucian Negreanu
European Journal of Inflammation.2020; 18: 205873922096289. CrossRef
Capsule endoscopy: Current status and role in Crohn’s disease
Loredana Goran, Ana Maria Negreanu, Ana Stemate, Lucian Negreanu
World Journal of Gastrointestinal Endoscopy.2018; 10(9): 184. CrossRef
Role of capsule endoscopy in suspected or established Crohn's disease in real practice
Hyun Joo Jang
Intestinal Research.2017; 15(4): 431. CrossRef

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Review

Non-steroidal anti-inflammatory drug-induced enteropathy: Sung Jae Shin, Choong-Kyun Noh, Sun Gyo Lim, Kee Myung Lee, Kwang Jae Lee; Intest Res 2017;15(4):446-455. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.446

Abstract PDF PubReader ePub

Non-steroidal anti-inflammatory drugs (NSAIDs) are well known to be associated with serious upper gastrointestinal complications, such as peptic ulcer, bleeding, perforation, and obstruction. Recently, attention has been mainly focused on the small bowel injuries caused by NSAIDs, and new endoscopic techniques such as capsule endoscopy and double balloon endoscopy can help in detecting such injuries. This article reviewed the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of small bowel injuries caused by NSAIDs. Small bowel injures by NSAIDs might occur with a similar frequency and extent as those observed in the upper gastrointestinal tract. The pathogenesis of NSAID-induced enteropathy is complex and not clearly understood. The various lesions observed in the small bowel, including petechiae, reddened folds, loss of villi, erosions, and ulcers can be detected by capsule endoscopy. A drug that could prevent or treat NSAID-induced enteropathy has not yet been developed. Therefore, further investigations should be performed to elucidate the pathogenesis of such enteropathy and develop suitable preventive and treatment strategies.

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Case Report

Capsule retention caused by duodenal metastases from primary appendiceal adenocarcinoma: Jen-Wei Chou, Ken-Sheng Cheng; Intest Res 2017;15(1):130-132. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.130

Abstract PDF PubReader ePub: Metastatic small bowel cancers are extremely rare in clinical practice. Primary appendiceal adenocarcinoma with gastrointestinal metastasis is seldom reported in the literature. Here, we describe the case of an 80-year-old male patient with primary appendiceal adenocarcinoma, who presented to China Medical University Hospital with mid-gastrointestinal tract bleeding. Capsule endoscopy revealed stenotic bowel lumen, but the capsule was retained in the distal duodenum. Double-balloon enteroscopy demonstrated erosive and erythematous mucosa in the region of capsule retention. The retained capsule was retrieved successfully by using an electrosurgical snare. Histological examination and immunohistochemical staining of the biopsy specimen from the duodenal lesion strongly supported the diagnosis of metastatic appendiceal adenocarcinoma.

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Reviews

The role of small bowel endoscopy in small bowel Crohn's disease: when and how?: Mikang Kim, Hyun Joo Jang; Intest Res 2016;14(3):211-217. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.211

Abstract PDF PubReader ePub

Endoscopy has a crucial role in the diagnosis, management, and surveillance of inflammatory bowel disease (IBD). It contributes in supporting the diagnosis of IBD with the clinical history, physical examination, laboratory findings, and targeted biopsies. Furthermore, endoscopy has a significant role in assessing disease activity and distribution in treatment efficacy evaluation, post-surgical recurrence risk, and cancer surveillance in patients with long-lasting illness. Endoscopy also provides therapeutic potential for the treatment of IBD, especially with stricture dilatation and treatment of bleeding. Small bowel (SB) endoscopy (capsule endoscopy and device-assisted enteroscopy) and cross-sectional radiologic imaging (computed tomography enterography and magnetic resonance enterography) have become important diagnostic options to diagnose and treat patients with SB Crohn's disease. We reviewed the present role of SB endoscopy in patients with SB Crohn's disease.

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Aptamer-Functionalized Microbubbles Targeted to P-selectin for Ultrasound Molecular Imaging of Murine Bowel Inflammation
Una Goncin, Laura Curiel, C. Ronald Geyer, Steven Machtaler
Molecular Imaging and Biology.2023; 25(2): 283. CrossRef
Utility of panenteric capsule endoscopy for the detection of small‐bowel Crohn's disease in patients with a normal magnetic resonance enterography: A prospective observational pilot study
Anuj Bohra, Diana Lewis, Jonathan P Segal, Abhinav Vasudevan, Daniel R Van Langenberg, Olga Niewiadomski
JGH Open.2023; 7(12): 966. CrossRef
Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study
Seong Ran Jeon, Jin-Oh Kim, Jeong-Sik Byeon, Dong-Hoon Yang, Bong Min Ko, Hyeon Jeong Goong, Hyun Joo Jang, Soo Jung Park, Eun Ran Kim, Sung Noh Hong, Jong Pil Im, Seong-Eun Kim, Ja Seol Koo, Chang Soo Eun, Dong Kyung Chang
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Small Bowel Enteroscopy – A Joint Clinical Guideline from the Spanish and Portuguese Small Bowel Study Groups
Enrique Pérez-Cuadrado-Robles, Rolando Pinho, Begoña Gonzalez, Susana Mão de Ferro, Cristina Chagas, Pilar Esteban Delgado, Cristina Carretero, Pedro Figueiredo, Bruno Rosa, Javier García Lledó, Óscar Nogales, Ana Ponte, Patrícia Andrade, Jose Francisco J
GE - Portuguese Journal of Gastroenterology.2020; 27(5): 324. CrossRef
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Eyal Klang, Marianne M Amitai, Adi Lahat, Doron Yablecovitch, Benjamin Avidan, Sandra Neuman, Nina Levhar, Noa Rozendorn, Batya Weiss, Shomron Ben-Horin, Rami Eliakim, Uri Kopylov
Journal of Crohn's and Colitis.2018; 12(3): 313. CrossRef
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Ki-Nam Shim, Seong Ran Jeon, Hyun Joo Jang, Jinsu Kim, Yun Jeong Lim, Kyeong Ok Kim, Hyun Joo Song, Hyun Seok Lee, Jae Jun Park, Ji Hyun Kim, Jaeyoung Chun, Soo Jung Park, Dong-Hoon Yang, Yang Won Min, Bora Keum, Bo-In Lee
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José Francisco Juanmartiñena Fernández, Ignacio Fernández-Urien Sainz, Beatriz Zabalza Ollo, Cristina Saldaña Dueñas, Marta Montañés Guimera, Alfonso Elosua González, Juan José Vila Costas
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Seong Ran Jeon, Jeong‐Sik Byeon, Hyun Joo Jang, Soo Jung Park, Jong Pil Im, Eun Ran Kim, Ja Seol Koo, Bong Min Ko, Dong Kyung Chang, Jin‐Oh Kim, Su Yeon Park
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Intestinal Research.2017; 15(4): 431. CrossRef

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Magnetic resonance enterography for the evaluation of the deep small intestine in Crohn's disease: Kazuo Ohtsuka, Kento Takenaka, Yoshio Kitazume, Toshimitsu Fujii, Katsuyoshi Matsuoka, Maiko Kimura, Takashi Nagaishi, Mamoru Watanabe; Intest Res 2016;14(2):120-126. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.120

Abstract PDF PubReader ePub

For the control of Crohn's disease (CD) a thorough assessment of the small intestine is essential; several modalities may be utilized, with cross-sectional imaging being important. Magnetic resonance (MR) enterography, i.e., MRE is recommended as a modality with the highest accuracy for CD lesions. MRE and MR enteroclysis are the two methods performed following distension of the small intestine. MRE has sensitivity and specificity comparable to computed tomography enterography (CTE); although images obtained using MRE are less clear compared with CTE, MRE does not expose the patient to radiation and is superior for soft-tissue contrast. Furthermore, it can assess not only static but also dynamic and functional imaging and reveals signs of CD, such as abscess, comb sign, fat edema, fistula, lymph node enhancement, less motility, mucosal lesions, stricture, and wall enhancement. Several indices of inflammatory changes and intestinal damage have been proposed for objective evaluation. Recently, diffusion-weighted imaging has been proposed, which does not need bowel preparation and contrast enhancement. Comprehension of the characteristics of MRE and other modalities is important for better management of CD.

Citations

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MR Enterography
Harsha K. Garg, Kumar K. Shashi, Jessica Kurian, Abbey J. Winant, Edward Y. Lee
Radiologic Clinics of North America.2025;[Epub] CrossRef
Motility Mapping Quantification Using the Classical Optical Flow Algorithm for Small Bowel Crohn’s Disease: Comparison with Balloon-assisted Enteroscopy Findings
Yoshio Kitazume, Kento Takenaka, Kazuo Ohtsuka, Yasuo Ozawa, Koichiro Kimura, Ryosuke Watanabe, Junichi Tsuchiya, Toshimitsu Fujii, Masakazu Nagahori, Mamoru Watanabe, Ukihide Tateishi
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Magnetic Resonance Enterography and Capsule Endoscopy in Patients Undergoing Patency Capsule for the Evaluation of Small Bowel Crohn’s Disease: A Korean Clinical Experience
Hyun Seok Lee, Yun Jeong Lim, Jin-Hee Jung, Ji Hyung Nam, Junseok Park, Sun Hyung Kang, Ki Bae Kim, Hoon Jai Chun
Gastroenterology Research and Practice.2020; 2020: 1. CrossRef
Efficacy of Novel Ultrathin Single-Balloon Enteroscopy for Crohn’s Disease: A Propensity Score-Matched Study
Kaoru Takabayashi, Naoki Hosoe, Motohiko Kato, Yukie Hayashi, Ryoichi Miyanaga, Kosaku Nanki, Kayoko Fukuhara, Yohei Mikami, Shinta Mizuno, Tomohisa Sujino, Makoto Mutaguchi, Makoto Naganuma, Naohisa Yahagi, Haruhiko Ogata, Takanori Kanai
Gut and Liver.2020; 14(5): 619. CrossRef
High b-value computed diffusion-weighted imaging for differentiating bowel inflammation in Crohn's disease
Yoshio Kitazume, Junichi Tsuchiya, Kento Takenaka, Kazuo Ohtsuka, Koichiro Kimura, Ryosuke Watanabe, Tomoyuki Fujioka, Toshimitsu Fujii, Mamoru Watanabe, Ukihide Tateisi
European Journal of Radiology.2020; 133: 109362. CrossRef
The role of small bowel endoscopy for Crohn's disease
Stefania Chetcuti Zammit, Pierre Ellul, Reena Sidhu
Current Opinion in Gastroenterology.2019; 35(3): 223. CrossRef
Magnetic resonance enterography predicts the prognosis of Crohn's disease
Ji Hoon Lee, Yong Eun Park, Nieun Seo, Hyun Jung Lee, Soo Jung Park, Tae Il Kim, Won Ho Kim, Joon Seok Lim, Jae Hee Cheon
Intestinal Research.2018; 16(3): 445. CrossRef
Quality Indicators for Small Bowel Capsule Endoscopy
Ki-Nam Shim, Seong Ran Jeon, Hyun Joo Jang, Jinsu Kim, Yun Jeong Lim, Kyeong Ok Kim, Hyun Joo Song, Hyun Seok Lee, Jae Jun Park, Ji Hyun Kim, Jaeyoung Chun, Soo Jung Park, Dong-Hoon Yang, Yang Won Min, Bora Keum, Bo-In Lee
Clinical Endoscopy.2017; 50(2): 148. CrossRef

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9 Crossref

Original Article

The role of capsule endoscopy in etiological diagnosis and management of obscure gastrointestinal bleeding: Vikas Pandey, Meghraj Ingle, Nilesh Pandav, Pathik Parikh, Jignesh Patel, Aniruddha Phadke, Prabha Sawant; Intest Res 2016;14(1):69-74. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.69

Abstract PDF PubReader ePub

Background/Aims

To investigate the various etiologies, yields, and effects of capsule endoscopy (CE) on management and complications, along with follow up of patients with obscure gastrointestinal (GI) bleeding.

Methods

The study group of patients included those having obscure, overt, or occult GI bleeding. The findings were categorized as (A) obvious/definitive, (B) equivocal, or (C) negative. Any significant alteration in patient management post CE in the form of drug or surgical intervention was noted.

Results

Total patients included in the study were 68 (48 males and 20 females). The ratio of male:female was 2.4:1. The age ranged between 16 years to 77 years. Mean age for males was 62±14 years, for females 58±16 years. The total yield of CE with definitive lesions was in 44/68 (65.0%) of patients. In descending order (A) angiodysplasia 16/68 (23.53%), (B) Crohn's disease 10/68 (14.70%), (C) non-steroidal anti-inflammatory drug enteropathy 8/68 (11.76%), (D) small bowel ulcers 4/68 (5.88%), (E) jejunal and ileal polyps 2/68 (2.94%), (F) intestinal lymphangiectasis 2/68 (2.94%), and (G) ileal hemangiomas 2/68 (2.94%) were followed. Equivocal findings 12/68 (17.65%) and negative study 12/68 (17.65%) was found. Complications in the form of capsule retention in the distal ileum were noted in 2/68 (2.94%) subjects. Statistically, there was a higher probability of finding the etiology if the CE was done during an episode of bleeding.

Conclusions

CE plays an important role in diagnosing etiologies of obscure GI bleeding. Its role in influencing the management outcome is vital.

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The Korean Journal of Gastroenterology.2016; 67(4): 165. CrossRef

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Review

Current status and future perspectives of capsule endoscopy: Hyun Joo Song, Ki-Nam Shim; Intest Res 2016;14(1):21-29. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.21

Abstract PDF PubReader ePub

Small bowel capsule endoscopy (CE) was first introduced 15 years ago, and a large amount of literature has since been produced, focused on its indication, diagnostic yields, and safety. Guidelines that have made CE the primary diagnostic tool for small bowel disease have been created. Since its initial use in the small bowel, CE has been used for the esophagus, stomach, and colon. The primary indications for small bowel CE are obscure gastrointestinal bleeding, unexplained iron deficiency anemia, suspected Crohn's disease, small bowel tumors, nonsteroidal anti-inflammatory drug enteropathy, portal hypertensive enteropathy, celiac disease, etc. Colon CE provides an alternative to conventional colonoscopy, with possible use in colorectal cancer screening. Guidelines for optimal bowel preparation of CE have been suggested. The main challenges in CE are the development of new devices with the ability to provide therapy, air inflation for better visualization of the small bowel, biopsy sampling systems attached to the capsule, and the possibility of guiding and moving the capsule by an external motion controller. We review the current status and future directions of CE, and address all aspects of clinical practice, including the role of CE and long-term clinical outcomes.

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Case Report

A Case of Localized Amyloid Light-Chain Amyloidosis in the Small Intestine: Jong Hyo Choi, Bong Min Ko, Cheol Kim, Hee Kyung Kim, Jae Pil Han, Su Jin Hong, Jong Ho Moon, Moon Sung Lee; Intest Res 2014;12(3):245-250. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.245

Abstract PDF PubReader ePub

Amyloidosis is characterized by the abnormal deposition of extracellular amyloid fibrils. Cases involving amyloid light-chain amyloidosis in the small intestine have been reported infrequently in Korea. Here, we report a case of localized light chain protein amyloidosis in the small intestine. Esophagogastroduodenoscopy, push enteroscopy, and capsule endoscopy revealed submucosal tumor-like lesions, multiple shallow ulcers, and several erosions in the distal duodenum and jejunum. An endoscopic biopsy established the diagnosis of amyloidosis. In through an immunohistochemical analysis, the presence of lambda light chain protein was detected. The patient had no evidence of an underlying clonal plasma cell disorder or additional organ involvement. Therefore, we concluded that the patient had localized amyloidosis of the small intestine.

Citations

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