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Bojórquez et al. Mini-invasive Surg 2023;7:8 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2022.65

Review Open Access

The why, when and how of small bowel and

panenteric capsule endoscopy in Crohn’s disease

Alejandro Bojórquez , Cristina Carretero
Digestive Diseases Service, Clínica Universidad de Navarra, Pamplona 31008, Spain.

Correspondence to: Dr. Cristina Carretero, Digestive Diseases Service, Clínica Universidad de Navarra, Avenida Pio XII, 36,
Pamplona 31008, Spain. E-mail: ccarretero@unav.es

How to cite this article: Bojórquez A, Carretero C. The why, when and how of small bowel and panenteric capsule endoscopy in
Crohn’s disease. Mini-invasive Surg 2023;7:8. https://dx.doi.org/10.20517/2574-1225.2022.65

Received: 5 Jul 2022 First Decision: 19 Dec 2022 Revised: 11 Feb 2023 Accepted: 10 Mar 2023 Published: 28 Mar 2023

Academic Editors: Giulio Belli, Jean François Rey Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Small bowel capsule endoscopy (SBCE) is a tool used for Crohn’s disease (CD) diagnosis and monitorization, which
aids in appropriate clinical decision-making, especially in the switch of treatment or withdrawal and influencing
reclassification of unclassified inflammatory bowel disease. Compared to cross-sectional imaging, namely
intestinal ultrasound and magnetic resonance enterography, SBCE has a superior diagnostic yield in proximal small
bowel inflammatory activity, which has been associated with greater morbidity. The risk of capsule retention is
higher in patients with established CD with suspected stenosis and those with suspected CD with obstructive
symptoms, known stenosis or previous small bowel resection. In these situations, SBCE should be administered
only after small bowel patency has been evaluated. There is evidence that the pan-enteric capsule (PEC) has a
higher diagnostic yield than ileocolonoscopy in detecting terminal ileum mucosal defects. Future research should
evaluate the PEC place in CD algorithms as it offers a non-invasive approach, which is especially important in a
long-term follow-up, likely diminishing the disease burden.

Keywords: Crohn’s disease, small bowel capsule endoscopy, pan-enteric capsule, Patency capsule

INTRODUCTION
The diagnosis of Crohn’s disease (CD) can often be challenging due to the absence of a single reference
standard. As a result, physicians are compelled to integrate the patient’s clinical manifestations with their
laboratory, imaging and histological data. CD is a pan-enteric, chronic inflammatory disease, with up to

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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