Aims:
Capsule enteroscopy (VCE) is considered the reference standard for the assessment of small bowel disorders since it has the highest diagnostic yield for the detection of luminal and mucosal alterations. There are no studies comparing VCE with small bowel ultrasonography (B-US): the aim of this study was to compare the diagnostic yield of VCE and B-US in the diagnosis of small bowel disorders.
Methods:
We retrospectively enrolled 159 patients undergoing VCE and B-US for the following indications: obscure gastrointestinal bleedings, suspect or follow-up of known complicated celiac disease, chronic diarrhoea or malabsorption syndromes. The interval between the two exams had to be inferior to one year. We evaluated the diagnostic yields of the two techniques. The accuracy of small bowel ultrasonography was determined using VCE as the reference standard.
Results:
The diagnostic yields calculated in the whole sample were 55% for VCE and 33% for B-US (P < 0.05). The subgroups analysis showed that VCE ability to detect pathological signs is higher; there was a statistical significant difference between the diagnostic performances of the two techniques in patients with OGIB (62% vs. 14%, P < 0.05) and suspect or known complicated celiac diseases (55% vs. 35%, P < 0.05), while the difference was not statistically significant among patients with chronic diarrhoea and malabsorption syndromes (51% vs. 46%, P = 0.8).
Conclusions:
Compared to B-US, VCE is more accurate to detect lesions in patients with OGIB and suspect or known complicated celiac disease. B-US could have a role in the screening of celiac disease complications, as it was able to detect patients with severe complications (RCD II, EATL, adenocarcinoma). In patients with chronic diarrhoea and malabsorption syndromes the use of VCE should be proposed earlier in the diagnostic process for its ability to detect clinically relevant lesions.
