Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis.

BACKGROUND: Wireless capsule endoscopy (WCE) is a new technology for small bowel imaging.

AIM: To report our initial experience with sensitivity of high quality enteroclysis in patients with small bowel ulcers detected by WCE.

METHODS: Medical records of all patients referred for WCE from December, 2001 to April, 2002 at our institution were reviewed. All patients had negative upper and lower endoscopies and small bowel barium studies before WCE.

RESULTS: There were 40 patients (19 female, mean age 57.3 yr) during this study period. Three patients had multiple small bowel ulcers detected by WCE. One with ileal ulcers and abdominal pain had an enteroclysis at another hospital before WCE. Review of the study at our institution showed that it was of excellent quality and was normal. Two patients with chronic iron deficiency anemia had multiple small bowel ulcers and were referred after WCE for a repeat small bowel barium study by biphasic enteroclysis performed by experienced GI radiologists. The radiologists were told in advance of the WCE findings. Both studies were considered technically to be of perfect quality. Despite this, both studies were negative. All 3 patients improved after therapy for Crohn's disease.

CONCLUSIONS: Our data indicates that WCE may be more sensitive for small bowel ulcers than the best enteroclysis available.