Small bowel lesions on enteroscopy after ileocolic resection

What is known

• Complete perioperative enteroscopy found endoscopic small-bowel lesions in 65% of patients operated for Crohn's, evenly distributed along the small bowel. ¹
• After ileocolic resection, endoscopic preanastomotic ileal ulceration was present in 73% at 3 months, 93% at 1 year, and 100% at 3 years, often preceding symptoms. ²
• Guidelines endorse DAE (with chromoendoscopy) to reach and assess anastomosis and small bowel deep to it, but do not cite a two-year lesion prevalence. ^3,4

What is unknown / caveats

• No retrieved study reports a DAE-specific proportion at a discrete 2-year post-resection timepoint
• Available figures derive from anastomotic ileoscopy and intraoperative/perioperative enteroscopy, not modern balloon-assisted DAE surveillance cohorts
• The exact 2-year DAE detection rate cannot be pinned down from the retrieved excerpts.

References

1. Lescut D, Vanco D, Bonnière P, Lecomte-Houcke M, Quandalle P, Wurtz A, Colombel JF, Delmotte JS, Paris JC, Cortot A. Perioperative endoscopy of the whole small bowel in Crohn's disease. Gut. 1993;34(5):647-9. PMID: 8504965.

2. [No authors listed]. Natural course of Crohn's disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms. Gut. 1992;33(3):331-5. PMID: 1568651.

3. Shen B, Kochhar GS, Navaneethan U, Cross RK, Farraye FA, Iacucci M, Schwartz DA, Gonzalez-Lama Y, Schairer J, Kiran RP, Kotze PG, Kobayashi T, Bortlik M, Liu X, Levy AN, González Suárez B, Tang SJ, Coelho-Prabhu N, Lukas M, Bruining DH, El-Hachem S, Charles RJ, Chen Y, Sood A, Mao R, Loras C, Dulai PS, Picoraro JA, Chiorean M, Shergill A, Silverberg MS, Sandborn WJ, Bernstein CN. Endoscopic evaluation of surgically altered bowel in inflammatory bowel disease: a consensus guideline from the Global Interventional Inflammatory Bowel Disease Group. Lancet Gastroenterol Hepatol. 2021;6(6):482-497. PMID: 33872568.

4. Gomollón F, Dignass A, Annese V, Tilg H, Van Assche G, Lindsay JO, Peyrin-Biroulet L, Cullen GJ, Daperno M, Kucharzik T, Rieder F, Almer S, Armuzzi A, Harbord M, Langhorst J, Sans M, Chowers Y, Fiorino G, Juillerat P, Mantzaris GJ, Rizzello F, Vavricka S, Gionchetti P, ECCO. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management. J Crohns Colitis. 2017;11(1):3-25. PMID: 27660341.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.