Evaluation of symptomatic small bowel stricture in Crohn’s disease by double-balloon endoscopy

Abstract

Purpose To assess the efficacy of double-balloon endoscopy (DBE) for the detection of small-bowel stricture in Crohn’s disease (CD). Methods This Tertiary-referral hospital cohort study was conducted between January 2018 and May 2022. CD patients with symptoms of small-bowel stricture were enrolled sequentially. All of the patients were subjected to both computed tomography enterography (CTE) and DBE, and their symptoms of stricture were assessed using the Crohn’s Disease Obstructive Score (CDOS). DBE diagnostic yield was compared to CTE, and the relationship between DBE findings and CDOS was investigated. The factors influencing DBE diagnosis were examined using Cox regression analysis. Results This study included 165 CD patients. CDOS scores were higher in 95 patients, while lower in 70. DBE detected 92.7% (153/165) and CTE detected 85.5% (141/165) of the strictures, respectively. DBE diagnostic yields were 94.7% (90/95) in high CDOS patients and 91.4% (64/70) in low CDOS patients (P = 0.13). Patients with a history of abdominal surgery and abscess had a lower diagnosis rate in the multivariate analysis. Conclusion DBE has been demonstrated to be an efficient diagnostic method for detecting small-bowel strictures in CD patients. Additionally, there is no difference in diagnostic yields between patients with low and high obstructive scores.