Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 31:izae192.
doi: 10.1093/ibd/izae192. Online ahead of print.

Endoscopic Skipping, Stricturing, and Penetrating Complications in Crohn's Disease on Tandem Ileo-colonoscopy and Cross-sectional Imaging: A Retrospective Cohort Study

Virginia Solitano  1   2 , Sudheer Kumar Vuyyuru  1 , Achuthan Aruljothy  1 , Maan Alkhattabi  1   3 , Joshua Zou  4 , Melanie Beaton  1 , Jamie Gregor  1 , Zahra Kassam  5 , Rocio Sedano  1   6 , Harry Marshall  5 , Darryl Ramsewak  5 , Michael Sey  1   7 , Vipul Jairath  1   5
Affiliations

Endoscopic Skipping, Stricturing, and Penetrating Complications in Crohn's Disease on Tandem Ileo-colonoscopy and Cross-sectional Imaging: A Retrospective Cohort Study

Virginia Solitano et al. Inflamm Bowel Dis. .

Erratum in

Abstract

Background: Crohn's disease (CD) is characterized by discontinuous inflammation. Failure to identify skipping lesions of the terminal ileum (TI) or transmural changes can lead to incorrect management.

Methods: Eligible adult patients with CD undergoing ileo-colonoscopy and computed tomography enterography or magnetic resonance enterography within 6 months. We determined the prevalence of endoscopic skipping (normal ileum on colonoscopy but proximal small bowel inflammation on cross-sectional imaging), skip lesions (discontinuous inflammation along the gastrointestinal tract identified on cross-sectional imaging), structuring, and penetrating complications.

Results: Among 202 patients, 45 (22.3%) had endoscopic skipping proximal to TI intubation. Fifty patients (24.5%) had small bowel skip lesions, primarily in the ileum. Strictures were identified in 34 patients (16.8%) through both imaging and ileo-colonoscopy, in 21 patients (10.4%) solely through cross-sectional imaging, and in 3 patients (1.5%) solely through ileo-colonoscopy. Approximately 36.2% of stricturing cases would be missed without cross-sectional imaging. Penetrating complications, including abscesses (2.5%) and various fistula types (4.9%), were detected in 15 (7.4%) patients.

Conclusions: Ileo-colonoscopy missed detection of active CD in approximately one-fifth of cases due to more proximal disease location. Stricturing disease might be missed in more than a third of cases if cross-sectional imaging is not performed.

Keywords: diagnosis; endoscopic skipping; inflammatory bowel disease; penetrating complications.

Plain language summary

Crohn’s disease often presents with discontinuous inflammation, with endoscopic evaluation sometimes missing proximal lesions. This study highlights the importance of cross-sectional imaging, which identifies skip lesions and strictures missed by endoscopy, crucial for accurate management.

PubMed Disclaimer

Similar articles

See all similar articles

LinkOut - more resources