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P234 The diagnostic yield of small bowel capsule endoscopy in postsurgical Crohn’s disease

N. Viazis*, L. Varitimiadis, M. Galanopoulos, A. Tsigaridas, M. Chanias, S. Anastasiadis, I. Tziortziotis, C. Pontas, E. Tsoukali, P. Karatzas, D. Karamanolis

Evangelismos Hospital, Gastroenterology Department, Athens, Greece

Background

Following ileocolonic resection for Crohn’s disease recurrence is frequent and unpredictable. In clinical practice, colonoscopy is recommended 6–12 months after surgery, to detect early recurrence and guide management. The aim of our study was to determine the diagnostic yield of small bowel capsule endoscopy in this setting.

Methods

We reviewed the records of 4 410 patients subjected to small bowel capsule endoscopy in our department from March 2003 to March 2015. Amongst those patients, we identified 691 with known Crohn’s disease, of whom 36 had been subjected to the test 6–12 months following ileocolonic resection. All of these patients had also been subjected to colonoscopy and we therefore assessed the findings of both examinations and graded the lesions observed in the neoterminal ileum according to the Rutgeerts index. Scores of  2 were classified as morphologic recurrence. The lesions detected by capsule endoscopy in the proximal small bowel were also recorded.

Results

Recurrence in the neoterminal ileum was detected in 13 patients during colonoscopy (36.1%). Small bowel capsule endoscopy detected lesions in the neoterminal ileum in 12 patients (33.3%), because in 1 patient with endoscopic recurrence detected by colonoscopy, the capsule did not reach the neoterminal ileum during the battery’s life span. However, more proximal small bowel involvement was detected in 11 patients (30.5%) during capsule endoscopy. From these patients, 8 also had lesions in the neoterminal ileum and 3 patients did not.

Conclusion

Small bowel capsule endoscopy is equal or even more effective than colonoscopy in identifying endoscopic recurrence in patients subjected to ileocolonic resection for Crohn’s disease.