Download PDF
Endoscopy 1998; 30(4): 339-344
DOI: 10.1055/s-2007-1001279
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Conflicting Results of Ileoscopy and Small Bowel Double-Contrast Barium Examination in Patients with Crohn's Disease

B. Tribll , K. Turetschek2 , G. Mostbeck2 , B. Schneider3 , C. Stain1 , R. Pötzi1 , A. Gangl1 , H. Vogelsang1
  • 1Clinic of Internal Medicine IV, Dept. of Gastroenterology and Hepatology, Vienna, Austria
  • 2Clinic of Radiology and Ludwig-Boltzmann-Institute for Radiologic Tumor Research, Vienna, Austria
  • 3Institute of Medical Statistics, University of Vienna, Austria
Further Information

Publication History

Publication Date:
17 March 2008 (online)

Also available at
  PDF Download  Permissions and Reprints

Abstract

Background and Study Aims: Ileoscopy has become a routine procedure for the diagnosis of Crohn's disease of the terminal ileum. The aim of this study was to compare the diagnostic accuracy of small bowel barium examination with that of ileoscopy.

Patients and Methods: In a retrospective study the two methods were compared in 55 patients with Crohn's disease. First, routine radiology reports and second, reevaluation of the small bowel barium study by gastrointestinal radiologists with scoring of examination quality were compared with the results of ileoscopy.

Results: Using routine radiology reports, 66 % sensitivity and 82 % specificity were reached for inflammatory changes of the terminal ileum by small bowel barium study. Sensitivity and specificity increased to 68 % and 91 % with double reading by experienced radiologists. Disagreement between endoscopic and radiologic results changed from 31 % to 27 % and were mainly because of false-negative barium studies. Sensitivity and specificity of barium studies were influenced by the quality of the examination with a sensitivity of 91 % and specificity of 100 % when the quality was good.

Conclusions: In patients in whom the terminal ileum is successfully intubated, ileoscopy is superior to barium examination in the evaluation of Crohn's disease of the terminal ileum. Results of the barium study were strongly influenced by the quality of the examination.