The relationship between jejunal-ileum lesions and terminal ileum lesions of isolated small intestinal Crohn disease under small bowel capsule endoscopy

Abstract

Objective To study the relationship between jejunal-ileum lesions and terminal ileum lesions of patients with isolated small intestinal Crohn disease, and to compare the clinical and endoscopic features of patients having normal terminal ileum with those having abnormal terminal ileum in isolated small intestinal Crohn disease. Methods The data of patients diagnosed as having isolated small intestinal Crohn disease and successively receiving colonoscopy and small bowel capsule endoscopy in Nanfang Hospital of Southern Medical University from January 2008 to October 2015 were retrospectively analyzed. The patients were divided into normal terminal ileum group and abnormal terminal ileum group according to the result of colonoscopy. The clinical and endoscopic features of the two groups were compared. Results The data of 62 patients were collected, and jejunal-ileum lesions were found in all of the patients under small bowel capsule endoscopy. According to the result of colonoscopy, 40 patients (64.5%) were grouped to the abnormal terminal ileum group and 22 patients (35.5%) to the normal group. The patients in the normal terminal ileum group had a shorter disease duration than those of the abnormal group [68.2%(15/22) VS 12.5%(15/40), P=0.021]. The sex and age distribution, smoking history, clinical feature, upper gastrointestinal involvement, perianal lesion, disease behavior, Crohn disease activity index, inflammation markers and nutriture between the two groups had no statistical difference (P>0.05). Conclusion The terminal ileum lesions found by colonoscopy cannot predict small bowel lesions for Crohn disease. Small bowel capsule endoscopy is helpful for the detection of small intestinal lesions in Crohn disease. We should pay more attention to evaluating the small bowel lesions when the patients with Crohn disease have a short duration and normal terminal ileum. Key words: Crohn disease; Colonoscopy; Capsule endoscopes; Intestine, small; Terminal ileum