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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(01): E32-E38
DOI: 10.1055/a-1978-6586
Original article

Endoscopic severity and classification of lesions with pan-enteric capsule endoscopy and ileocolonoscopy in ileocolonic Crohn’s disease

Jacob Broder Brodersen
1   Department of Internal Medicine, Section of Gastroenterology, Hospital of South West Jutland, Esbjerg, Denmark
2   Department of Regional Health Research, University of Southern Denmark, Denmark
,
Jens Kjeldsen
3   Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark
4   Research Unit of Medical Gastroenterology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
5   OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
,
Torben Knudsen
1   Department of Internal Medicine, Section of Gastroenterology, Hospital of South West Jutland, Esbjerg, Denmark
2   Department of Regional Health Research, University of Southern Denmark, Denmark
,
Michael Dam Jensen
2   Department of Regional Health Research, University of Southern Denmark, Denmark
6   Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital, Vejle, Denmark
› Author AffiliationsSupported by: Region of Southern Denmark 16/9780 & 19/37100
Supported by: The Danish Colitis and Crohn’s Association
Supported by: Research Council Lillebaelt Hospital

TRIAL REGISTRATION: Prospective cohort study NCT03134586 at ClinicalTrials.gov (http://www.clinicaltrials.gov/)
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Abstract

Background and study aims Recent evidence supports the use of pan-enteric capsule endoscopy (CE) for the diagnosis and follow-up of Crohn’s disease (CD). The aim of this study was to examine the agreement between CE and ileocolonoscopy (IC) for determining the severity and classification of lesions in ileocolonic CD.

Patients and methods In a prospective blinded multicenter study, patients with suspected CD were examined with CE and IC within 2 weeks. Ninety-nine participants with a full IC and CE were included in the analysis. The ileocolonic disease severity was assessed with the Simple Endoscopic Score for Crohn’s Disease (SES-CD).

Results CD was diagnosed in 30 patients with IC and CE. The mean SES-CD was 9.8 (CI 7.9–11.8) and 10.6 (CI 8.2–13.1), respectively (P = 0.69). There was a substantial agreement (ICC 0.83, CI 0.68–0.92) and a strong correlation between SES-CD assessed with IC and CE (rs = 0.78, P < 0.001). 55 bowel segments had ulcerations with both modalities (terminal ileum 24, right colon 12, transverse colon eight, left colon eight and rectum three). Mean sub-scores for ulcer size, area of ulcerated surface and area of affected surface did not differ between modalities. The inter-modality agreement (κ) was 0.46, 0.34 and 0.43, respectively (P < 0.001).

Conclusions There is a strong correlation between IC and CE for the severity of ileocolonic CD. The agreement for SES-CD sub-scores is fair to moderate. CE could be an alternative to IC for the assessment of endoscopic severity in selected patients with suspected CD.



Publication History

Received: 20 June 2022

Accepted after revision: 11 November 2022

Accepted Manuscript online:
14 November 2022

Article published online:
04 January 2023

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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