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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(10): E1005-E1012
DOI: 10.1055/a-2180-9537
Original article

Additional information obtained from mucosal biopsies is limited after pan-enteric capsule endoscopy in patients with suspected Crohn’s disease

Sofia Hjerrild Thomsen
1   Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital, Vejle, Denmark (Ringgold ID: RIN371420)
,
Pantea Zinolabedinbik
1   Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital, Vejle, Denmark (Ringgold ID: RIN371420)
,
Jacob Broder Brodersen
2   Department of Internal Medicine, Section of Gastroenterology, Hospital South West Jutland, Esbjerg, Denmark (Ringgold ID: RIN532010)
,
Torben Knudsen
2   Department of Internal Medicine, Section of Gastroenterology, Hospital South West Jutland, Esbjerg, Denmark (Ringgold ID: RIN532010)
,
Jens Kjeldsen
3   Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark (Ringgold ID: RIN11286)
,
Michael Dam Jensen
2   Department of Internal Medicine, Section of Gastroenterology, Hospital South West Jutland, Esbjerg, Denmark (Ringgold ID: RIN532010)
› Author Affiliations TRIAL REGISTRATION: Registration number (trial ID): NCT03134586, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Prospective, multicenter study
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Abstract

Background and study aims Pan-enteric capsule endoscopy (CE) is an emerging alternative to ileo-colonoscopy for diagnosing Crohn’s disease (CD). However, CE does not offer the opportunity to take biopsies to support the diagnosis. This study examined the additional information obtained with mucosal biopsies and the feasibility of CE as a single diagnostic procedure.

Patients and methods This retrospective study was based on a prospective, blind multicenter trial in which patients with suspected CD were examined with ileo-colonoscopy plus segmental biopsies and CE. Histopathological findings were compared to the result of CE.

Results A total of 107 patients with a complete CE were included in the analysis. CE was consistent with CD in 44 patients (41.1%) and ulcerative colitis in 10 patients (9.3%). Histopathology confirmed the result of CE in 39.3% of patients and added new diagnostic information in 6.5% of patients. A CE consistent with CD was histologically confirmed in 20.5% of patients. Biopsies most often showed non-specific inflammation (61.4%). Only one patient with a normal CE had a specific histological diagnosis (microscopic colitis). Biopsies altered the diagnosis of ulcerative colitis to CD in two patients, and in two patients with a normal CE, biopsies showed CD or ulcerative colitis. In one patient with lymphoma in the terminal ileum and cecum, CE was misinterpreted as CD.

Conclusions In patients with suspected CD and an evident result of CE, the additional information obtained from biopsies is limited, and CE as a single diagnostic procedure might be feasible in selected patients. Biopsies are warranted, however, in patients with an atypical endoscopic appearance or suspected malignancy.

Keywords

Endoscopy Lower GI Tract - Endoscopy Small Bowel - Inflammatory bowel disease - Capsule endoscopy - Tissue diagnosis


Publication History

Received: 25 May 2023

Accepted after revision: 14 September 2023

Accepted Manuscript online:
25 September 2023

Article published online:
17 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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