Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn's disease in small bowel capsule endoscopy: An international Delphi consensus statement.

Leenhardt, Romain;Buisson, Anthony;Bourreille, Arnaud;Marteau, Philippe;Dray, Xavier;et.al.
(2020) United European Gastroenterology Journal — Vol. 8, n° 1, p. 99-107 (2020)

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Authors
  • Leenhardt, Romain
    Author
  • Buisson, Anthony
    Author
  • Bourreille, Arnaud
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  • Marteau, Philippe
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  • Pérez-Cuadrado Robles, Enriqueorcid-logoUCLouvain
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  • Dray, Xavier
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Abstract
BACKGROUND: In the medical literature, the nomenclature and descriptions (ND) of small bowel (SB) ulcerative and inflammatory (U-I) lesions in capsule endoscopy (CE) are scarce and inconsistent. Inter-observer variability in interpreting these findings remains a major limitation in the assessment of the severity of mucosal lesions, which can impact negatively on clinical care, training and research on SB-CE. OBJECTIVE: Focusing on SB-CE in Crohn's disease (CD), our aim is to establish a consensus on the ND of U-I lesions. METHODS: An international panel of experienced SB-CE readers was formed during the 2016 United European Gastroenterology Week meeting. A core group of five CE and inflammatory bowel disease (IBD) experts established an Internet-based, three-round Delphi consensus but did not participate in the voting process. The core group built illustrated questionnaires, including SB-CE still frames of U-I lesions from patients with documented CD. Twenty-seven other experts were asked to rate and comment on the different proposals for the ND of the most frequent SB U-I lesions. For each round, we used a 6-point rating scale (varying from 'strongly disagree' to 'strongly agree'). The consensus was reached when at least 80 % of the voting members scored the statement within the 'agree' or 'strongly agree' categories. RESULTS: A 100% participation rate was obtained for all the rounds. Consensual ND were reached for the following seven U-I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia and denudation. CONCLUSION: Considering the most frequent SB U-I lesions seen in CE in CD, a consensual ND was reached by the international group of experts. These descriptions and names are useful not only for daily practice and medical education, but also for medical research.
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Leenhardt, R., Buisson, A., Bourreille, A., Marteau, P., Koulaouzidis, A., Li, C., Keuchel, M., Rondonotti, E., Toth, E., Plevris, J. N., Eliakim, R., Rosa, B., Triantafyllou, K., Elli, L., Wurm Johansson, G., Panter, S., Ellul, P., Pérez-Cuadrado Robles, E., McNamara, D., et al. (2020). Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn’s disease in small bowel capsule endoscopy: An international Delphi consensus statement. United European Gastroenterology Journal, 8(1), 99-107. https://doi.org/10.1177/2050640619895864 (Original work published 2020)