Journal of Yeungnam Medical Science

Original article

Comparison of small bowel findings using capsule endoscopy between Crohn’s disease and intestinal tuberculosis in Korea: Yong Gil Kim, Kyung-Jo Kim, Young-Ki Min; Yeungnam Univ J Med. 2020;37(2):98-105. Published online November 22, 2019; DOI: https://doi.org/10.12701/yujm.2019.00374

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Background
Little is known about capsule endoscopy (CE) findings in patients with intestinal tuberculosis who exhibit small bowel lesions. The aim of the present study was to distinguish between Crohn’s disease (CD) and intestinal tuberculosis based on CE findings.
Methods
Findings from 55 patients, who underwent CE using PillCam SB CE (Given Imaging, Yoqneam, Israel) between February 2003 and June 2015, were retrospectively analyzed.
Results
CE revealed small bowel lesions in 35 of the 55 patients: 19 with CD and 16 with intestinal tuberculosis. The median age at diagnosis for patients with CD was 26 years and 36 years for those with intestinal tuberculosis. On CE, three parameters, ≥10 ulcers, >3 involved segments and aphthous ulcers, were more common in patients with CD than in those intestinal tuberculosis. Cobblestoning was observed in five patients with CD and in none with intestinal tuberculosis. The authors hypothesized that a diagnosis of small bowel CD could be made when the number of parameters in CD patients was higher than that for intestinal tuberculosis. The authors calculated that the diagnosis of either CD or intestinal tuberculosis would have been made in 34 of the 35 patients (97%).
Conclusion
The number of ulcers and involved segments, and the presence of aphthous ulcers, were significantly higher and more common, respectively, in patients with CD than in those with intestinal tuberculosis. Cobblestoning in the small bowel may highly favor a diagnosis of CD on CE.

Citations

Citations to this article as recorded by

Deep Learning Radiomics Analysis of CT Imaging for Differentiating Between Crohn’s Disease and Intestinal Tuberculosis
Ming Cheng, Hanyue Zhang, Wenpeng Huang, Fei Li, Jianbo Gao
Journal of Imaging Informatics in Medicine.2024;[Epub] CrossRef
Differentiating gastrointestinal tuberculosis and Crohn's disease- a comprehensive review
Arup Choudhury, Jasdeep Dhillon, Aravind Sekar, Pankaj Gupta, Harjeet Singh, Vishal Sharma
BMC Gastroenterology.2023;[Epub] CrossRef
Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease
M. N. Reshetnikov, D. V. Plotkin, Yu. R. Zyuzya, A. A. Volkov, O. N. Zuban, E. M. Bogorodskaya
Acta Biomedica Scientifica.2021; 6(5): 196. CrossRef
Differentiating intestinal tuberculosis and Crohn disease: Quo Vadis
Vishal Sharma
Expert Review of Gastroenterology & Hepatology.2020; 14(8): 647. CrossRef

Original Article

The Usefulness of Capsule Endoscopy in Diagnosis of Small Bowel Diseases.: Jong Ryul Eun, Byung Ik Jang; Yeungnam Univ J Med. 2006;23(1):45-51. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.45

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Abstract PDF: BACKGROUND
This study was conducted to evaluate the usefulness of capsule endoscopy (CE) for the diagnosis of small bowel diseases. MATERILAS AND METHODS: We reviewed the medical records of 66 patients (mean age: 52.1 years, male/female: 39/27), who underwent CE at Yeungnam University Hospital from August 2003 to March 2006. RESULTS: Suspicious gastrointestinal (GI) bleeding presenting as anemia or history of gross bleeding was the most common reason to perform CE (71.2%). Other indications included GI symptoms (21.2%) such as abdominal pain/discomfort, nausea, diarrhea, and others (7.6%). In studies performed for GI bleeding (n=47), ulcer/erosion was the most common finding (n=22, 46.8%) followed by tumor (n=5, 10.6%), angiodysplasia (n=3, 6.4%), polyp (n=3, 6.4%), active bleeding (n=1, 2.1 %), ulcer with stenosis (n=1, 2.1%), and normal findings (n=12, 25.5%). Of these, a bleeding focus was detected in 32 cases (68.1%) undergoing CE studies. Among 14 patients with GI symptoms, only two patients had typical findings related with symptoms. Surgical resection was performed in five cases with tumor. Of these, four were diagnosed as gastrointestinal stromal tumor and the other one was a lymphangioma. There were no complications associated with the CE procedure. CONCLUSION: Capsule endoscopy is a safe, noninvasive diagnostic tool for small bowel diseases and may be useful for the diagnosis of small bowel hemorrhage including obscure bleeding. However, further studies are needed to confirm its utility for abdominal symptoms other than hemorrhage because of the low diagnostic yield.

Case Report

Two Cases of Jejunal Gastrointestinal Stromal Tumor Diagnosed by Capsule Endoscope.: Jae Won Choi, Ji Eun Lee, Byung Ik Jang, Tae Nyeun Kim, Sun Kyo Song, Young Kyong Bae; Yeungnam Univ J Med. 2006;23(1):131-137. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.131

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Abstract PDF: Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.

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