Background: Owing to the development of double-balloon enteroscopy (DBE) and video capsule endoscopy (VCE)\nin recent years, direct visualization of the entire small intestinal mucosa has become possible. Because of the\nnonspecific symptoms and the anatomic location of the small bowel, diagnosis of isolated small bowel Crohnâ??s\ndisease (CD) remains a challenge. The aim of this research was to explore the value of DBE for isolated small bowel\nCD in situations where routine tests cannot confirm the diagnosis.\nMethods: This study included patients with suspected isolated small bowel CD who were hospitalized in Shengjing\nHospital from April 2014 to June 2018. We included patients presenting with chronic diarrhea, abdominal pain,\nabdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding\ninfection factors. Patients with purely colonic CD were excluded from this cohort. Patients with suspected isolated\nsmall bowel CD underwent DBE.\nResults: In 16/18 patients, pathological findings were detected by DBE. In 12 of the cases, small bowel CD was\nconfirmed. The remaining four patients were diagnosed with small bowel inflammation, duodenal carcinoma, ileum\ninflammation and small bowel ulcers. However, the diagnosis of CD was confirmed in 14/18 (78%) patients by\ntaking into account the clinical presentation, endoscopic and histological results as well as the experimental\ntreatment. DBE assisted in the diagnosis in 86% (12/14) of the patients.\nConclusions: In the diagnosis of small bowel CD, DBE is a helpful tool. Before assessment with DBE, clinical\nfeatures, colonoscopy, and CT were used to initially assess the intestine. According to the lesions indicated by CT,\nwe chose the most appropriate endoscope insertion route, and combined the endoscopic characteristics and\npathological results of DBE to confirm the diagnosis.
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