Review Article

Capsule Endoscopy for Crohn’s Disease: Current Status of Diagnosis and Management

Table 2

Comparison of video capsule endoscopy with computed tomography enterography or enteroclysis: diagnostic yield or performance for suspected or established Crohn’s disease.

StudyDesignNumber of casesTestsDefinition/description for positive findingsDiagnostic yieldSensitivity/specificity

Voderholzer et al. (2005) [20]Prospective41 established CDVCESmall lesions (aphthoid ulcerations, villous denudation, and patchy erythema) and large lesions (such as cobblestone pattern, deep/fissural ulcerations)61%NA
CTECContrast enhancement of the mucosa and the other bowel wall layers, increased density of the peri-intestinal fat representing inflammatory changes and increased vascularity, separation of bowel loops, and possible lymphadenopathy
The length and location of stenotic areas, the presence of fistulae, ulcerations, pseudodiverticulae, and polypous changes of the mucosa
29%NA

Eliakim et al. (2004) [12]Prospective35 suspected CDVCEUlcers/erosions, erythema, aphthae, and nodular lymphoid hyperplasia77%NA
CTEWall thickening, nodularity in terminal ileum, and ulcers20%NA

Hara et al. (2006) [21]Prospective17 (8 suspected and 9 established CD)VCEErosions, ulcers, or strictures71%NA
CTEIncreased mucosal or wall enhancement, bowel wall thickening > 3 mm, fistulas, or abscesses53%NA

Solem et al. (2008) [23]Prospective27VCENA(1)NA83%/53%
CTENA(1)NA82%/89%

Jensen et al. (2011) [22]Prospective80VCE(2)More than 3 ulcerations (aphthous lesions or ulcers), irregular ulcers/fissures, or stenosis caused by fibrosis or inflammation30%(3)100%/91%
CTE(2)Mucosal ulcerations, bowel wall thickening, bowel wall hyperenhancement, small bowel stenosis, creeping fat, dilated vasa recta, and the presence of an abscess or fistula in conjunction to a diseased small bowel segment33%(3)76%/85%

CD, Crohn’s disease; VCE, video capsule endoscopy; NA, not available; CTEC, computed tomography enteroclysis; CTE, computed tomography enterography.
(1)No specific criteria for positive findings of CD were provided in the text. Diagnosis was made by a consensus panel of the coinvestigators in this study.
(2)VCE and CTE were performed for 69 of 80 and 73 of 80 patients, respectively.
(3)Diagnostic yield for terminal ileal CD.