Characteristics of small bowel lesions and disease evaluation in Crohn’s disease by Capsule endoscopy

Abstract

Abstract Purpose Early endoscopic diagnosis and evaluation of small bowel Crohn’s disease (CD) have been important and challenging. This study aimed to investigate features of small bowel lesion in CD detected by capsule endoscopy (CE) as well as mucosal evaluation performance compared to clinical activity. Methods In this retrospective study, we collected baseline CE data of 60 small bowel CD patients. Characteristics of lesions location and features were summarized. Lesions of location difference were compared by McNemar's test. Lewis score (LS) and Crohn’s Disease Activity Index (CDAI) were used to evaluate disease activity independently, correlation was analyzed by Spearman's rank correlation test. Results Under CE, ulceration shape presented by irregular (76.7%), longitudinal (66.7%), oval (40%) and circular (8.3%). Some lesions were arranged by longitudinally (36.7%) and circumferentially (23.3%). Prevalence of cobblestone appearance and longitudinal arrangement in jejunum was higher than in ileum (P < 0.05). In small bowel and colon involvement, LS was weakly connected with CDAI (r = 0.367, P༜0.05), while in isolated small bowel CD, no significant correlation was found (P > 0.05). Conclusion Ulcer shape of small bowel CD is diverse. Cobblestone appearance tends to occur in jejunum and may result in poor prognosis. Multi-segment small oval or irregular ulcer arranged by longitudinally in jejunum may be a clue for CD early diagnosis. CDAI may underestimate mucosal inflammation. LS is necessary for small bowel CD for accurate evaluation.