Su1165 Serum Alpha-1-Antitrypsin: A Non-Invasive Marker of Pouchitis

Abstract

106 DBEs were performed in 61 patients. (47 oral , 59 anal) with total enteroscopy achieved in 30%; 69% had history of previous surgical resection. Among those with established DBE, findings led to escalation of medical therapy in 30%, maintenance of therapy in 25%, and referral to surgery (25% resection, 8% bowel preservating). 4 patients underwent repeat DBE for disease monitoring after therapeutic escalation. Among 61 patients with known CD, 17 underwent dilation of 67 strictures during 32 endoscopic sessions. Of these patients, 65% were surgery-free during the study period. In those with CD diagnosis made at time of index DBE, 23 DBEs were performed in 18 patients (11 oral, 12 anal). Of these, 1 had total enteroscopy and 2/2 had successful capsule retrieval. All patients had previously undergone ileocolonoscopy and small bowel imaging without an established diagnosis (Table). Overall, there was one perforation in a patient with CD and a prior surgical resection; no patients developed DBE-associated pancreatitis or died during immediate followup period. Conclusions: Diagnostic and therapeutic DBE is safe and effective in patients with suspected or established CD, even in high risk patients with previous small bowel resection. DBE identified small bowel stricturing disease missed on prior ileocolonoscopy and small bowel imaging studies, and offers therapeutic potential for stricturing disease that might otherwise require surgery. Operating Characteristics of Small Bowel Imaging and Ileocolonoscopy for the Diagnosis of Isolated Small Bowel Crohn's Disease Using DBE as Reference