Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Capsule enteroscopy versus small-bowel ultrasonography for the detection and differential diagnosis of intestinal diseases

  • Luca Elli (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Erica Centorrino (Department of Pathophysiology and Transplantation, University of Milan) ;
  • Andrea Costantino (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Maurizio Vecchi (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Stefania Orlando (Department of Pathophysiology and Transplantation, University of Milan) ;
  • Mirella Fraquelli (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico)
  • Received : 2021.08.27
  • Accepted : 2022.02.25
  • Published : 2022.07.30
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Abstract

Background/Aims: Capsule enteroscopy (CE) and intestinal ultrasonography (IUS) are techniques that are currently used for investigating small-bowel (SB) diseases. The aim of this study was to compare the main imaging findings and the lesion detection rate (LDR) of CE and IUS in different clinical scenarios involving the SB. Methods: We retrospectively enrolled patients who underwent CE and IUS for obscure gastrointestinal bleeding (OGIB), complicated celiac disease (CeD), and suspected or known inflammatory bowel disease (IBD). We evaluated the LDR of both techniques. The accuracy of IUS was determined using CE as the reference standard. Results: A total of 159 patients (113 female; mean age, 49±19 years) were enrolled. The LDR was 55% and 33% for CE and IUS (p<0.05), respectively. Subgroup analysis showed that the LDR of CE was significantly higher than that of IUS in patients with OGIB (62% vs. 14%, p<0.05) and CeD (55% vs. 35%, p<0.05). IUS showed a similar LDR to CE in patients with suspected or known IBD (51% vs. 46%, p=0.83). Conclusions: CE should be preferred in cases of OGIB and CeD, whereas IUS should be considered an early step in the diagnosis and follow-up of IBD even in patients with a proximal SB localization of the disease.

Keywords

Acknowledgement

The authors are thankful to the members of the Center for Prevention and Diagnosis of Celiac Disease of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milan) for previous data storage.

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