Prospective Comparison of Small Bowel Meal with Pneumocolon versus Ileo-Colonoscopy for the Diagnosis of Ileal Crohn's Disease

Marshall, John K.; Cawdron, Ruth; Zealley, Ian; Riddell, Robert H.; Somers, Sat; Irvine, E. Jan

doi:10.1111/j.1572-0241.2004.30499.x

Cited by 27 publications

(19 citation statements)

References 22 publications

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“…In a study by Marshall et al [13] , BMFTP was found to be as accurate as ileoscopy in diagnosing ter minal ileal disease. Minordi et al [14] showed that combining pneumocolon with BMFT improved the identification of terminal ileal and cecal lesions.…”

Section: Discussionmentioning

confidence: 99%

Barium meal follow through with pneumocolon: Screening test for chronic bowel pain

Nijhawan¹,

Kumpawat²,

Mallikarjun³

et al. 2008

WJG

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AIM:To study the sensitivity, specificity and cost effectiveness of barium meal follow through with pneumocolon (BMFTP) used as a screening modality for patients with chronic abdominal pain of luminal origin in developing countries. M E T H O D S : F i f t y p a t i e n t s a t t e n d i n g t h eGastroenterology Unit, SMS Hospital, whose clinical evaluation revealed chronic abdominal pain of bowel origin were included in the study. After routine testing, BMFT, BMFTP, contrast enhanced computed tomography (CECT) of the abdomen, barium enema and colonoscopy were performed. The sensitivity, specificity and cost effectiveness of these imaging modalities in the detection of small and/or large bowel lesions were compared. RESULTS: Out of fifty patients, structural pathology was found in ten. Nine out of these ten patients had small bowel involvement while seven had colonic involvement alone or in combination with small bowel involvement. The sensitivity of BMFTP was 100% compared to 88.89% with BMFT when detecting small bowel involvement (BMFTP detected one additional patient with ileocecal involvement). The sensitivity and specificity of BMFTP for the detection of colonic pathology were 85.71% and 95.35% (41/43), respectively. Screening a patient with chronic abdominal pain (bowel origin) using a combination of BMFT and barium enema cost significantly more than BMFTP while their sensitivity was almost comparable. CONCLUSION: BMF TP should be included in the investigative workup of patients with chronic abdominal pain of luminal origin, where either multiple sites (small and large intestine) of involvement are suspected or the site is unclear on clinical grounds. BMFTP is an economical, quick and comfortable procedure which obviates the need for colonoscopy in the majority of patients.

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Section: Discussionmentioning

confidence: 99%

Barium meal follow through with pneumocolon: Screening test for chronic bowel pain

Nijhawan¹,

Kumpawat²,

Mallikarjun³

et al. 2008

WJG

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“…Endoscopy with biopsy by a push endoscope is safe and useful procedure in selected patients with suggestive symptoms and failure of conventional radiology. Ileoscopy is superior for the diagnosis of CD of the terminal ileum when compared to small bowel radiology, whether performed as SBFT, enteroclysis or meal with pneumocolon [30] .…”

Section: Crohn's Disease (Cd)mentioning

confidence: 99%

Inflammatory Bowel Diseases: Controversies in the Use of Diagnostic Procedures

Vucelić¹

2009

Dig Dis

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The term inflammatory bowel disease (IBD) denotes a genetically, immunologically and histopathologically heterogeneous group of inflammatory bowel disorders classified at present time as ulcerative colitis (UC), Crohn’s disease (CD) and indeterminate colitis (IC). Diagnosis of IBD is based on a non-strictly defined combination of clinical and diagnostic parameters. In order to guide the treatment, patients must be assessed by determining IBD phenotype, disease extension and distribution, extraintestinal manifestations, disease behavior, disease severity and drug responsiveness. Each element of the diagnostic process cannot be looked at alone, but has to be incorporated into general clinical assessment, bearing in mind that different phenotypes and age groups require specific diagnostic solutions. Advances in technology provided the possibility for the assessment of the entire digestive system with endoscopy leading the way. Sophisticated imaging methods made the analysis of the bowel wall with its vascularity and adjacent mesentery possible. The challenge is still the small bowel, where a combination of endoscopy and imaging methods is used. The use of imaging methods should be, among other things, guided by level of irradiation which is especially important in young patients and in patients requiring repeated investigations. Using abdominal ultrasound as a low-cost, noninvasive procedure, one has to take into account that it is very operator-dependent method. In UC, endoscopy is used for the evaluation of the extent and activity of the disease and to assess complications like stricture, dysplasia and cancer. UC is classified by the disease extent into proctitis, left-sided colitis and extensive colitis beyond the splenic flexure. Pediatric patients with UC have more extensive disease than adults with rectal sparing in up to 30% of patients. The severity of mucosal changes are reported as Baron endoscopic score. Endoscopic findings correlate well with clinical activity and are commonly incorporated into Mayo index, combination of clinical Truelove Witts index and Baron score. Complications like strictures require imaging methods as supplement to endoscopy. The incidence of CD, particularly in children and adolescents, has risen during the past decade, with children often having extensive and severe disease The nature of CD requires the use of wide array of endoscopic and imaging methods, placed properly in the diagnostic algorithms for specific disease phenotypes and complications and adapted for specific age groups. Endoscopic features of CD are very variable and can be quantified as Crohn’s Disease Endoscopic Index of Severity (CDEIS) or Simple Endoscopic Score for CD (SES-CD). Disease activity is most commonly assessed by CDAI. Perianal disease activity should be measured by PDAI due to low CDAI scores in these patients. The activity of CD in children should be assessed by the Pediatric Activity Index. IC is part of the IBD spectrum where chronic colitis cannot be defined as either UC or CD after sequential co...

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“…Conventional endoscopic examinations used in the diagnosis of CD may not always provide enough data about the localization and the extension of the disease (1,2). As stated in the CD guidelines of ECCO (European Crohn's & Colitis Organization), the involvement area and the extension of the disease must be determined in order to plan an optional treatment (3).…”

Section: Introductionmentioning

confidence: 99%

What is the most accurate method for the assesment of small bowel in involvement in Crohn’s disease?

Çekiç¹,

Ünsal²

2010

Turk J Gastroenterol

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Prospective Comparison of Small Bowel Meal with Pneumocolon versus Ileo-Colonoscopy for the Diagnosis of Ileal Crohn's Disease

Cited by 27 publications

References 22 publications

Barium meal follow through with pneumocolon: Screening test for chronic bowel pain

Barium meal follow through with pneumocolon: Screening test for chronic bowel pain

Inflammatory Bowel Diseases: Controversies in the Use of Diagnostic Procedures

What is the most accurate method for the assesment of small bowel in involvement in Crohn’s disease?

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