INFORMATION AND REFERENCES

The Simple Endoscopic Score for Crohn Disease (SES-CD) assesses the size of mucosal ulcers, the ulcerated surface, the endoscopic extension and the presence of stenosis. It has been developed as an alternative to CDEIS, it is simpler and therefore more suited to a routine use. During the validation process, a strong correlation between SES-CD and CDEIS (r = 0.920) as been seen. In addition, SES-CD correlates with clinical parameters and serum levels of C-reactive protein.

The calculation scheme is as follows.
SES-CD calculation table

Ileum Right
colon		 Transverse
colon		 Left colon
and sigma		 Rectum Total
Ulcers?
0: no
1: aphthous (0.1-0.5 cm)
2: large (0.5-2 cm)
3: very large (>2 cm) 		___+ ___+ ___+ ___+ ___= ___+
Surface involved by disease
0: 0%
1: <50%
2: 50-75%
3: >75% 		___+ ___+ ___+ ___+ ___= ___+
Surface involved by ulcerations
0: 0%
1: <10%
2: 10-30%
3: >30%		 ___+ ___+ ___+ ___+ ___= ___+
Narrowings?
0: No
1: Single, can be passed
2: Multiple, can be passed
3: Cannot be passed		 ___+ ___+ ___+ ___+ ___= ___+
Grand Total = SES-CD score

Decoding table (2)

Score Decoding
0 - 2 remission
3 - 6 mild endoscopic activity
7 - 15 moderate endoscopic activity
> 15 severe endoscopic activity

A decrease of 50% of the SES-CD score has recently been proposed as prognostically significant.



Below are some examples endoscopic images.


Ulcers: none Aphtous ulcers
(<0.5 cm)
Large ulcers
(from 0.5 to 2 cm)		 Very large ulcers
(>2 cm)
Impassable stenosis Single stenosis,
can be passed

Surface involved by ulcerations

Surface
involved
by ulcerations
0% (none)		 Surface
involved
by ulcerations
<10%
3% lesion9% lesion
Surface involved by ulcerations
10%-30%
22% lesion25% lesion
 Surface involved by ulcerations
>30%
52% lesion66% lesion
References
  • Daperno M, D'Haens G, Van Assche G, Baert F, Bulois P, Maunoury V, Sostegni R, Rocca R, Pera A, Gevers A, Mary JY, Colombel JF, Rutgeerts P. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc 2004; 60 (4): 505-512.
  • Moskovitz DN, Daperno M, Van Assche G. Defining and validating cut-offs for the Simple Endocopic Score for Crohn's Disease. Gastroenterology 2007; 132: S1097.