Diagnostic Agreement between Capsule Endoscopy and Double-balloon Enteroscopy of Small Bowel Disease / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: To evaluate the diagnostic agreement between capsule endoscopy (CE) and double-balloon enteroscopy (DBE) in patients with suspected small bowel disease. METHODS: We retrospectively analyzed and compared the diagnostic yield and the diagnostic agreement between CE and DBE, in patients who initially underwent CE followed by DBE at a single tertiary referral center. RESULTS: Thirty patients (17 males, mean age 45+/-17) underwent both CE and DBE. Total small bowel examination was possible in 80% (24/30) with CE, and 20% (6/30) with DBE. Diagnostic yield was 56.7% (17/30) with CE, and 73.3% (22/30) with DBE. Overall diagnostic yield was 93.3% (28/30) after both examinations. The overall degree of concordance between CE and DBE for lesion description was a moderate agreement, with a calculated kappa index of 0.48 (95% CI 0.44~0.52, p<0.05). Both CE and DBE detected identical lesions relevant to the clinical presentation in 56.6% (17/30) of cases. A total of 36.7% (11/30) of cases changed diagnosis because different lesions were detected by each method. CONCLUSIONS: The overall degree of concordance between CE and DBE showed moderate agreement. Additional DBE examinations can improve the diagnostic yield of small bowel lesions in patients with no relevant findings or failed detection on CE, who are, however, clinically suspicious.