P0346The Clinical Value of Double-Balloon Enteroscopy Combined with Small Intestinal Endoscopic Ultrasound in the Follow-Up of Small Intestinal Crohn’s Disease: a retrospective study

Background To investigate the clinical value of double-balloon enteroscopy (DBE) combined with small intestinal endoscopic ultrasound (SIEUS) in the follow-up of small Intestinal Crohn’s disease (CD). Methods A total of 55 CD patients from October 2022 to December 2023 were consecutively enrolled. Follow-up evaluations, including repeat DBE and SIEUS, were conducted between January 2024 and December 2024. Clinical data pre- and post- treatment were collected. Statistical analyses were performed to compare these parameters pre- and post-treatment. Results (1) Laboratory parameters: C-reactive protein (CRP) showed significant improvement post-treatment (P < 0.05). (2) Disease activity: Pre-treatment: 38 cases (69.1%) were in mild activity, and 17 (30.9%) in moderate activity. mpSES-CD scores were 1–4 in 37 cases (67.3%) and 5–8 in 18 (32.7%). Post-treatment: 43 cases (78.2%) achieved remission, 12 (21.8%) remained in mild activity, and all patients exhibited mpSES-CD scores of 1–4 (100%). (3) Intestinal wall thickness: Pre-treatment total wall thickness: 4.36±0.29 mm. Post-treatment total thickness decreased to 2.55±0.45 mm, with statistically significant reductions in total wall thickness, submucosa, and muscularis propria (P < 0.05). (4) Layer clarity: Pre-treatment: 29 cases showed distinguishable submucosa/muscularis propria boundaries. Post-treatment: 37 cases demonstrated clear boundaries with statistically significant improvements (P < 0.05). Conclusion SIEUS enhances the evaluation of CD treatment efficacy by quantifying intestinal wall layer thickness and layer clarity, effectively addressing the limitations of white-light endoscopy in assessing vertical infiltration depth. The combination of DBE and SIEUS improves diagnostic accuracy and provides valuable clinical guidance for optimizing CD treatment strategies. References: 1. Cholapranee A, Hazlewood GS, Kaplan GG, et al. Systematic review with meta-analysis: comparative efficacy of biologics for induction and maintenance of mucosal healing in Crohn’s disease and ulcerative colitis controlled trials. Aliment Pharmacol Ther. 2017;45:1291–1302. 2. Peng B, Liu Z, Huang Z, et al. Comparative analysis of enteroscopy, computed tomography enterography, and intestinal ultrasound for the evaluation of small bowel Crohn’s disease. Therap Adv Gastroenterol. 2025;18:17562848251318031. 3. Li CQ, Xie XJ, Yu T, et al. Classification of inflammation activity in ulcerative colitis by confocal laser endomicroscopy. Am J Gastroenterol. 2010;105:1391–6. 4. Ellrichmann M, Wietzke-Braun P, Dhar S, et al. Endoscopic ultrasound of the colon for the differentiation of Crohn’s disease and ulcerative colitis in comparison with healthy controls. Aliment Pharmacol Ther. 2014;39:823–33. Conflict of interest: Mr. Liu, Zhongcheng: No conflict of interest Guo, Qin: No conflict of interest