Correlation of the endoscopic findings for small and large bowels in pediatric patients with established Crohn’s disease

Okuhira, Takeru; Yoden, Atsushi; Aomatsu, Tomoki; Akamatsu, Masano; Inoue, Kazuo; Kaji, Emiri; Takitani, Kimitaka; Tamai, Hiroshi

doi:10.3164/jcbn.18-83

Cited by 3 publications

(8 citation statements)

References 43 publications

(67 reference statements)

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“…In contrast, several studies reported correlations between SBCE findings and biomarkers including CRP, ESR, and FC levels. [20][21][22][23][24][25][26] We also reported previously that FC levels were correlated with SB lesion activity, although colonic inflammation evaluated by colonoscopy was poorly correlated with LS. 25 In the present study, however, the cut-off value of FC is higher than the previous meta-analysis study that the FC cut-off value was 100 lg/g for small bowel CD.…”

Section: Discussionmentioning

confidence: 81%

“…[20][21][22][23][24][25][26] We also reported previously that FC levels were correlated with SB lesion activity, although colonic inflammation evaluated by colonoscopy was poorly correlated with LS. 25 In the present study, however, the cut-off value of FC is higher than the previous meta-analysis study that the FC cut-off value was 100 lg/g for small bowel CD. 44 This may be due to the fact that most of participating subjects had small and large bowel type Crohn's disease.…”

Section: Discussionmentioning

confidence: 81%

“…We defined LS < 135 as inactive SB, as described previously 30 . The LS had been used for the evaluation of SB activity with pediatric patients in some studies although it had not been well validated in the children with CD 25,31–33 …”

Section: Methodsmentioning

confidence: 99%

“…18 Fecal calprotectin levels increase in pediatric patients and adults with CD; 19 however, it is unclear how closely these levels reflect SB lesion activity. [20][21][22][23][24][25][26] This study aimed to assess the accuracy of IUS in evaluating SB lesion activity in pediatric patients with established CD.…”

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confidence: 99%

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Usefulness of ultrasonography for small intestinal evaluations in pediatric Crohn's disease

Okuhira

Yoden

Kaji

et al. 2022

Pediatrics International

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Background Small bowel capsule endoscopy (SBCE) for Crohn's disease is useful; however, its use has some limitations, such as invasiveness when endoscopic assistance is required in patients who cannot swallow the capsule, and the burden of interpretation on a physician. In contrast, intestinal ultrasonography (IUS) is a non‐invasive modality for children. The purpose of this study is to evaluate the accuracy of IUS for pediatric patients with established Crohn's disease. Methods Small bowel capsule endoscopy and IUS findings from the same period in pediatric patients with established Crohn’s disease were analyzed retrospectively. First, we compared the Lewis score (LS), small bowel endoscopic activity, and IUS findings by small bowel wall thickness (SBWT) and mesenteric lymph node size (MLNS). Second, we compared the performance of IUS findings with those of some biomarkers. Results In 22 procedures, SBWT and MLNS were correlated with LS (r = 0.52, P < 0.05, and r = 0.45, P < 0.05, respectively). Small bowel wall thickness, erythrocyte sedimentation rate, and fecal calprotectin levels had the highest accuracy (81.8%, 81.8%, and 81.8%, respectively). The combination of SBWT and MLNS had the highest positive predictive value and negative predictive value (100% and 83.3%, respectively). Conclusions Intestinal ultrasonography findings, including SBWT and MLNS, are useful for monitoring small bowel lesions in pediatric patients with established Crohn’s disease. We suggest first evaluating small bowel inflammation by IUS in pediatric patients with Crohn’s disease before SBCE because IUS is less invasive than SBCE.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Usefulness of ultrasonography for small intestinal evaluations in pediatric Crohn's disease

Okuhira

Yoden

Kaji

et al. 2022

Pediatrics International

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“…[ 21 ] As an important tool for the exploration of small bowel diseases, VCE is of vital importance for CD patients. [ 22 ] UC is restricted to the colon; however, a few cases of UC with gastroduodenal lesions and small bowel lesions have also recently been reported. [ 23 – 25 ] In our study, 180 patients were diagnosed with IBD (160 CD, 20 UC).…”

Section: Discussionmentioning

confidence: 99%

Clinical features of capsule endoscopy in 825 children

Huang

Wang

et al. 2020

Medicine

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Video capsule endoscopy (VCE) can detect mucosal lesions in the intestine, especially in the small bowel. Our study aims to evaluate the applications of VCE for pediatric gastrointestinal diseases. In this retrospective study, we included all patients who underwent VCE between December 2012 and December 2018. Clinical information and VCE data were analyzed. Among 828 patients, the completion rate was 99.6% (n = 825), with an average age of 10.2 ± 3.3 years old. A total of 459 VCE procedures showed abnormalities, and the overall diagnostic yield was 55.6%. The most common indications for VCE were abdominal pain among 505 (61.2%) patients and hematochezia (10.1%) among 83. Among the positive results of VCE, small bowel ulcers accounted for the highest percentage (57.7%), of which 164 cases were diagnosed as inflammatory bowel disease. For obscure gastrointestinal bleeding, 12 cases were diagnosed as Meckel's diverticulum. In terms of the small bowel transit time of VCE, compared with the negative group [288 (216.5, 390.3) min] and the enteritis group [277 (192.5, 374.8) min], a longer transit time was needed in the small bowel ulcer group [332.5 (240, 451.5) min, P < .01]. There were no correlations of positive VCE findings with anemia, the white blood cell count, the C-reactive protein level or the small bowel transit time according to Spearman rank analysis. VCE is relatively well tolerated and safe in children and has great value for the diagnosis and treatment of abdominal pain, especially inflammatory bowel disease and obscure gastrointestinal bleeding.

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Draft clinical guidelines for endoscopic diagnosis of ulcerative colitis in children

Лохматов

Budkina

Хавкин

et al. 2022

jour

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The article summarizes clinical guidelines for endoscopic examinations (esophagogastroduodenoscopy, ileocolonoscopy, video capsule endoscopy) in children with ulcerative colitis (UC). Such issues of endoscopic examinations and monitoring of UC as indications for primary and repeated examinations, technical aspects of examinations, biopsy, endoscopic activity indices and endoscopic semiotics of UC, the role of video capsule endoscopy are considered.

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Correlation of the endoscopic findings for small and large bowels in pediatric patients with established Crohn’s disease

Cited by 3 publications

References 43 publications

Usefulness of ultrasonography for small intestinal evaluations in pediatric Crohn's disease

Usefulness of ultrasonography for small intestinal evaluations in pediatric Crohn's disease

Clinical features of capsule endoscopy in 825 children

Draft clinical guidelines for endoscopic diagnosis of ulcerative colitis in children

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