Korean J Gastrointest Endosc > Volume 40(4); 2010 > Article
Korean Journal of Gastrointestinal Endoscopy 2010;40(4): 236-243.
캡슐내시경과 이중풍선 소장내시경의 소장병변의 진단 일치도
김현건ㆍ김진오ㆍ이태희ㆍ김완중ㆍ최현숙ㆍ조영관ㆍ조원영ㆍ고봉민ㆍ조주영ㆍ이문성ㆍ이준성
순천향대학교 의과대학 내과학교실, 소화기연구소
Diagnostic Agreement between Capsule Endoscopy and Double-balloon Enteroscopy of Small Bowel Disease
Hyun Gun Kim, M.D., Jin-Oh Kim, M.D., Tae Hee Lee, M.D., Wan Jung Kim, M.D., Hyun Sook Chol, M.D., Young Kwan Cho, M.D., Won Young Cho, M.D., Bong Min Ko, M.D., Joo Young Cho, M.D., Moon Sung Lee, M.D. and Joon Seong Lee, M.D.
Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea
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. (Korean J Gastrointest Endosc 2010;40:236-243)
Key Words: Capsule endoscopy, Double-balloon enteroscopy, Concordance
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