Original articleClinical endoscopyColon capsule endoscopy compared with other modalities in the evaluation of pediatric Crohn’s disease of the small bowel and colon
Section snippets
Patients
Eligible patients were recruited at the Pediatric Gastroenterology and Liver Unit of the Sapienza University of Rome, a tertiary-care referral pediatric center for inflammatory bowel disease (IBD), between September 2013 and July 2014. Inclusion criteria were as follows: age 6 to 18 years, diagnosis of CD at least 3 months before enrollment, and need for endoscopy and imaging follow-up. Exclusion criteria were as follows: dysphagia, renal insufficiency, known stricturing CD identified by
Primary endpoint
The intent of the study was to assess disease activity in the small bowel and colon, classify pediatric CD patients as normal or with active inflammation, and to calculate the diagnostic accuracy of CCE. Colon disease activity was assessed according to the simple endoscopic score for CD19 that was calculated for each colon segment; the overall score for each patient was obtained by adding the scores of each individual segment. For our primary end-point and according to the literature, we
Results
Of 40 patients enrolled (22 male, 18 female, mean age 13.1 ± 3.1 years; mean disease duration: 37.3 ± 26.1 months), 2 patients were excluded because of inability to swallow the capsule, leaving 38 patients available for analysis (Fig. 1, Table 1). Thirty patients underwent colonoscopy in the afternoon of the day of CCE, whereas 8 patients proceeded the day after, because of the lack of capsule excretion before the end of battery life.
Discussion
This study, which used CCE in pediatric patients with Crohn’s disease, demonstrated the ability of a single, minimally invasive tool to evaluate the mucosa of both the small bowel and the colon concurrently with high diagnostic accuracy, safety, and tolerability, enabling the ability to monitor mucosal activity of the entire intestinal tract in a manner that previously required both standard capsule endoscopy and colonoscopy in pediatric patients.
CCE performed well in the colon, providing
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DISCLOSURE: C. Hassan and S. Cohen are consultants for Given Imaging. All other authors disclosed no financial relationships relevant to this article.
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