Abstract 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
Liu et al. (2026) studied this question.