NOMENCLATURE AND SEMANTIC DESCRIPTIONS OF ULCERATIVE AND INFLAMMATORY LESIONS SEEN IN CROHN’S DISEASE IN SMALL BOWEL CAPSULE ENDOSCOPY: AN INTERNATIONAL DELPHI CONSENSUS STATEMENT

Aims Nomenclature and description of small bowel (SB) ulcerative and inflammatory (U-I) lesions in capsule endoscopy (CE) are scarce in the medical literature. Interobserver variability in interpreting the findings remains a major limitation for the assessment of severity of mucosal lesions with a potential negative impact on clinical care, training and research regarding SBCE. Our aim is to establish a consensus on the nomenclature and the description of U-I lesions seen in SB CE in Crohn’s Disease (CD).

Methods An international panel of experienced SB CE readers was formed during the 2016 UEGW meeting. A core group of 5 CE and inflammatory bowel disease (IBD) experts established an internet-based three-round Delphi consensus, but did not participate in voting process. The core group built illustrated questionnaires including various still frames of SB U-I CE lesions obtained from CD patients. A group of 27 other experts was asked to rate and comment different proposals on the nomenclature and the description of the most frequent SB U-I lesions. A 6-point rating scale (varying from ‘strongly disagree’ to ‘strongly agree’) was used in successive rounds. The consensus was reached when at least 80 % voting members scored the statement within the ‘agree’ or ‘strongly agree’.

Results A 100% participation rate was obtained in all rounds. Consensual nomenclature and descriptions were reached for the following seven U-I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia, and denudation.

Conclusions A consensual nomenclature and description of the most frequent SB U-I lesions seen in CE in CD has been reached by an international group of experts. Such names and descriptions are useful for daily practice, medical education and medical research purposes.