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BACKGROUND AND AIMS:
Data on the colon capsule endoscopy (CCE) in evaluating the small bowel (SB) and colon concurrently are rare. This study aims to evaluate the accuracy of CCE in assessing disease activity of the SB and colon in pediatric CD, by comparison with magnetic resonance enterography (MRE), SB contrast ultrasonography (SICUS), and ileocolonoscopy.
METHODS:
We prospective enrolled 40 consecutive patients (22 males, 18 females, mean age 13.1 ± 3.1 years) with CD of SB and colon. All underwent SICUS, MRE, CCE and ileocolonoscopy sequentially over 5 days. All investigators were blinded to the patient history and to test results. Patients were classified as "active" or "inactive" for the SB and the colon according to specific criteria for each tool (SES-CD, Lewis score, US and MR parameters of activity). For colonic mucosa evaluation, ileocolonoscopy was the comparator. For the SB a consensus panel was convened.
RESULTS:
Sensitivity of CCE to detect colonic inflammation was 89% and specificity was 100%. The PPV and NPV of CCE for colonic inflammation were 100% and 91% respectively. In the SB, CCE showed 90% SE, 94% SP, with PPV and NPV of 95% and 90% respectively. Accuracy parameters for SICUS (SE: 90%, SP: 83%) and MRE (SE: 85%, SP: 89%) were lower than those for CCE. No serious adverse event related to the CCE procedure or preparation was reported.
CONCLUSION:
CCE is of great usefulness in evaluating both SB and colon mucosa in pediatric CD. This single, non-invasive tool makes it possible to evaluate the SB and the colon concurrently with high diagnostic accuracy. Future multicenter studies need to define the role of CCE in the routine management of pediatric CD patients.
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