Yeungnam Univ J Med.  2020 Apr;37(2):98-105. 10.12701/yujm.2019.00374.

Comparison of small bowel findings using capsule endoscopy between Crohn’s disease and intestinal tuberculosis in Korea

  • 1Department of Internal Medicine, Soonchunhyang University College of Medicine, Gumi, Korea
  • 2Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 3Department of Physiology, Soonchunhyang University College of Medicine, Cheonan, Korea


Little is known about capsule endoscopy (CE) findings in patients with intestinal tuberculosis who exhibit small bowel lesions. The aim of the present study was to distinguish between Crohn’s disease (CD) and intestinal tuberculosis based on CE findings.
Findings from 55 patients, who underwent CE using PillCam SB CE (Given Imaging, Yoqneam, Israel) between February 2003 and June 2015, were retrospectively analyzed.
CE revealed small bowel lesions in 35 of the 55 patients: 19 with CD and 16 with intestinal tuberculosis. The median age at diagnosis for patients with CD was 26 years and 36 years for those with intestinal tuberculosis. On CE, three parameters, ≥10 ulcers, >3 involved segments and aphthous ulcers, were more common in patients with CD than in those intestinal tuberculosis. Cobblestoning was observed in five patients with CD and in none with intestinal tuberculosis. The authors hypothesized that a diagnosis of small bowel CD could be made when the number of parameters in CD patients was higher than that for intestinal tuberculosis. The authors calculated that the diagnosis of either CD or intestinal tuberculosis would have been made in 34 of the 35 patients (97%).
The number of ulcers and involved segments, and the presence of aphthous ulcers, were significantly higher and more common, respectively, in patients with CD than in those with intestinal tuberculosis. Cobblestoning in the small bowel may highly favor a diagnosis of CD on CE.


Capsule endoscopy; Crohn disease; Small intestine; Tuberculosis


  • Fig. 1. Capsule endoscopy reveals multiple aphthous ulcers (arrows) in patients with Crohn’s disease (A) and intestinal tuberculosis (B).

  • Fig. 2. Capsule endoscopy reveals linear ulcers (arrow) in patients with Crohn’s disease (A) and intestinal tuberculosis (B).

  • Fig. 3. Capsule endoscopy reveals cobblestone features in patients with Crohn’s disease.

  • Fig. 4. Capsule endoscopy reveals strictures in patients with Crohn’s disease (A) and intestinal tuberculosis (B).



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