Virtual colonoscopy compared with conventional colonoscopy for stricturing postoperative recurrence in Crohn's disease

Inflamm Bowel Dis. 2003 Nov;9(6):343-50. doi: 10.1097/00054725-200311000-00001.


Background: The place of virtual colonoscopy (VC) in patients with Crohn's disease (CD) requiring endoscopic follow-up after surgery is unknown. The authors compared findings from VC versus conventional colonoscopy (CC) for assessing the postoperative recurrence of CD.

Methods: Sixteen patients with ileocolonic anastomosis for CD were prospectively enrolled from January 2001 to January 2002. Recurrence was assessed by CC according to Rutgeerts et al. VC was performed with a computed tomography scanner, with images examined by three radiologists who were unaware of the endoscopic findings.

Results: CC showed perianastomotic recurrence in 15 of 16 patients. Perianastomotic narrowing or stenosis was detected by VC in 11 of these 15 patients. There were 11 true positive, 1 true negative, 0 false-positive, and 4 false-negative findings (73% sensitivity, 100% specificity, 100% positive predictive value, 20% negative predictive value, 75% accuracy). Among the eight patients showing a rigid stenosis of the anastomosis not allowing passage of the colonoscope, VC detected narrowing or stenosis in seven patients.

Conclusions: The current findings suggest that although the widespread use of VC in CD is currently not indicated because of possible false-negative findings, this technique may represent an alternative to CC in noncompliant postsurgical patients with a rigid stenosis not allowing passage of the endoscope.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Colon / surgery
  • Colonography, Computed Tomographic*
  • Colonoscopy*
  • Constriction, Pathologic
  • Crohn Disease / diagnosis*
  • Crohn Disease / pathology
  • Crohn Disease / surgery*
  • Female
  • Humans
  • Ileum / surgery
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Predictive Value of Tests
  • Recurrence
  • Sensitivity and Specificity