Wireless Capsule Endoscopy in the Evaluation of Patients with Suspected or Known Crohn’s Disease

Wireless capsule endoscopy (WCE) is a novel, noninvasive technique that can detect obscure mucosal lesions along the entire length of the small bowel. Early systematic studies of WCE in patients with Crohn’s disease suggest that this technique is a very effective diagnostic tool in patients with a high clinical probability of having the disease, but whose classic endoscopic and radiographic studies have been negative. It is likely that WCE will replace radiographic studies in this setting in the near future. A careful clinical history must be taken and imaging studies of the small bowel are mandatory prior to WCE in patients with inflammatory bowel disease, in order to avoid the rare complication of capsule retention in intestinal strictures, although the use of the ”patency capsule” will probably greatly facilitate the exclusion of relevant strictures in the near future.

References

• 1 Papadakis K A, Tabibzadeh S. Diagnosis and misdiagnosis of inflammatory bowel disease.  Gastrointest Endosc Clin N Am. 2002;  12 433-449
• 2 Fireman Z, Mahajna E, Broide E. et al . Diagnosing small bowel Crohn’s disease with wireless capsule endoscopy [see Comment].  Gut. 2003;  52 390-392
• 3 Mow W S, Lo S K, Targan S R. et al . Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease.  Clin Gastroenterol Hepatol. 2004;  2 31-40
• 4 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy.  Nature. 2000;  405 417
• 5 Lo S K. Capsule endoscopy in the diagnosis and management of inflammatory bowel disease.  Gastrointest Endosc Clin N Am. 2004;  14 179-193
• 6 Swain P. Wireless capsule endoscopy.  Gut. 2003;  52 (Suppl 4) iv48-iv50
• 7 Appleyard M, Fireman Z, Glukhovsky A. et al . A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions.  Gastroenterology. 2000;  119 1431-1438
• 8 Costamagna G, Shah S K, Riccioni M E. et al . A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease [see Comment].  Gastroenterology. 2002;  123 999-1005
• 9 Eliakim R, Fischer D, Suissa A. et al . Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease.  Eur J Gastroenterol Hepatol. 2003;  15 363-367
• 10 Eliakim R, Adler S N. Capsule video endoscopy in Crohn’s disease: the European experience.  Gastrointest Endosc Clin N Am. 2004;  14 129-137
• 11 Hollerbach S, Kraus K, Willert J. et al . Endoscopically assisted video capsule endoscopy of the small bowel in patients with functional gastric outlet obstruction.  Endoscopy. 2003;  35 226-229
• 12 Lo S K, Zaidel O, Tabibzadeh S. et al . Utility of wireless capsule enteroscopy (WCE) and IBD serology in re-classifying indeterminate colitis (IC).  Gastroenterology. 2003;  124 A192
• 13 Seidman E G, Sant’Anna A M, Dirks M H. Potential applications of wireless capsule endoscopy in the pediatric age group.  Gastrointest Endosc Clin N Am. 2004;  14 207-217