Does capsule endoscopy have an added value in patients with perianal disease and a negative work up for Crohn's disease? |
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作者姓名: | Adler SN Yoav M Eitan S Yehuda C Eliakim R |
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作者单位: | Departments of Gastroenterology,Bikur Holim Hospital,Jerusalem,91104(ASN,MY),Asaf Harofeh,Zrifin 70300(ES),and Rambam Health Care Campus,Haifa 31096(CY,ER),Israel |
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摘 要: | AIM:To investigate the role of capsule endoscopy in patients with persistent perianal disease and negative conventional work up for Crohn’s disease(CD).METHODS:Patients with perianal disease(abscesses,fistulas,recurrent fissures) were evaluated for underlying CD.Patients who had a negative work up,defined as a negative colonoscopy with a normal ileoscopy or a normal small bowel series or a normal CT/MR enterography,underwent a Pillcam study of the small bowel after signing informed consent.Patients using nonsteroidal anti-inflammatory drugs or who had a history of inflammatory bowel disease or rheumatic disease were excluded.RESULTS:We recruited 26 patients aged 21-61 years(average 35.6 years),17 males and 9 females.One case could not be evaluated since the capsule did not leave the stomach.In 6 of 25(24%) patients with a negative standard work up for Crohn’s disease,capsuleendoscopy(CE) findings were consistent with Crohn’s disease of the small bowel.Family history of CD,white blood cell,hemoglobin,erythrocyte sedimentation rate or C-reactive protein did not predict a diagnosis of CD.Capsule endoscopy findings led to a change in treatment.CONCLUSION:In patients with perianal disease and a negative conventional work up to exclude CD,CE leads to incremental diagnostic yield of 24%.
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关 键 词: | Perianal abscess Perianal fistula Ileocolonoscopy Capsule endoscopy Crohn’s disease |
收稿时间: | 2011 Nov 8 |
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