Abstract
Recently, the diagnosis and the treatment of small intestinal inflammatory disorders have been advanced by the progress of the diagnostic instruments including capsule endoscopy (CE), balloon endoscopy (BE), CT-enterography and MRI.
CE is useful when deciding on the treatment strategy of the small intestinal inflammatory disorders by evaluating disease severity (ex. the Lewis score), reactivity to treatment and appropriateness of the treatment. The diagnostic utility of CE for small intestinal Crohn's disease has been reported as well as an evaluation of the NSAID induced small intestinal mucosal injuries in Europe and the USA. In other words, it has been reported that CE produced a higher detection rate of ulcerative lesions in small intestinal Crohn's disease than the enteroclysis and other examination.
BE is mainly applied for confirmational diagnosis and therapeutic procedures (including hemostasis, balloon dilatation) of small bowel disorders. In addition, BE is useful for diagnosis of OGIB cases with evident active bleeding and mucosal healing of small intestinal Crohn's disease. Furthermore, the endoscopic balloon dilatation for the small intestinal stenosis of Crohn's disease has consistently helped to avoid surgery.
However, the utility of CE and BE for the diagnosis of stenoses and fistula formation is low, and it seems that enteroclysis is superior. It is thought that CT-enterography and MRI supplement this and contribute to the evaluation of inflammation of intestinal wall, but more improvement of these techniques is necessary.
This report introduces the present conditions and topics based mainly on a literature review about the utility and limitations of these examinations. In addition, we show the images of these examinations in some cases with small intestinal inflammatory disorders.
