Korean J Intern Med > Volume 41(5); 2026 > Article
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Korean J Intern Med. 2026;41(5):785-798.         doi: https://doi.org/10.3904/kjim.2025.402
Optimizing multiple diagnostic modalities for small bowel evaluation: a strategic approach
Dong Jun Oh, and Yun Jeong Lim
Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
Corresponding Author: Yun Jeong Lim  , Tel: +82-31-961-7133, Email: drlimyj@gmail.com
Received: December 8, 2025;   Revised: February 10, 2006;   Accepted: March 20, 2026.
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Abstract
Over the past two decades, the small bowel, once considered a diagnostic “blind spot,” has become fully and comprehensively accessible. This review summarizes recent advances in the main diagnostic modalities: capsule endoscopy (CE), device-assisted enteroscopy (DAE), computed tomography enterography (CTE), magnetic resonance enterography (MRE), and intestinal ultrasound (IUS). CE provides a noninvasive assessment of mucosal abnormalities, whereas DAE offers the added benefits of tissue sampling and therapeutic intervention. CTE and MRE provide complementary cross-sectional information on mural inflammation, strictures, and extraintestinal involvement. IUS has emerged as a valuable, radiation-free technique for repeated bedside monitoring. We review the diagnostic performance, strengths, and limitations of each modality in key clinical scenarios, including suspected small bowel bleeding, Crohn’s disease, and tumors. Finally, we highlight the importance of an integrated, patient-centered approach to optimize the evaluation of small bowel disease and to guide clinical decision-making.
Keywords: Small intestine ; Capsule endoscopy ; Balloon enteroscopy ; Diagnostic imaging
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