Abstract
Background and study aims
The aim of this study was to analyze the contribution of the double-balloon enteroscopy (DBE) for diagnosis of the small bowel disorders.
Patients and Methods
Forty-four patients (20 women, 24 men; mean age 53.5 years-old, range 21–89 years) with chronic gastrointestinal bleeding, diarrhea, polyposis, weight-loss, Roux-en-Y surgery, and other indications underwent DBE.
Results
Twenty patients had occult or obscure gastrointestinal bleeding. The source of bleeding was identified in 15/20 (75%): multiple angiodysplasias in four, arterial-venous malformation beyond the ligament of Treitz in two that could be treated with injection successfully. Other diagnoses included: duodenal adenocarcinoma, jejunal tuberculosis, erosions and ulcer of the jejunum. Of 24 patients with other indications, the diagnosis could be achieved in 18 of them (75%), including: two lymphomas, plasmocytoma, Gardner’s syndrome, Peutz-Jeghers’ syndrome, familial adenomatous polyposis, Behçet’s disease, jejunal submucosal lesion, lymphangiectasia due to blastomycosis and unspecific chronic jejunitis. Of three cases with Roux-en-Y reconstruction, two underwent DBE in order to perform biopsies of the excluded duodenum. Additionally, two patients underwent DBE to exclude Crohn’s disease and lymphoma of the small bowel. The mean length of small bowel examination was 240 ± 50 cm during a single approach. The diagnostic yield was 75% (33/44 cases) and therapeutic yield was 63.6%. No major complications were observed, only minor complication such as sore throat in 4/44 (9.1%).
Conclusions
1. DBE is a safe and and accurate method to diagnose small bowel disorders; 2. this method permits chromoscopy, biopsies and treatment of the lesions.
Similar content being viewed by others
References
De Leusse A, Landi B, Edery J, Burtin P, Lecomte T, Seksik, Bolch F, Jian R, Cellier C (2005) Video capsule endoscopy for investigation of obscure gastrointestinal bleeding: feasibility, results, and interobserver agreement. Endoscopy 37: 617–621
Ell C, May A, Nachbar L, Cellier C, Landi B, Di Caro S, Gasbarrini A (2005) Push-and-pull enteroscopy in the small bowel using the double-balloon technique: results of a prospective European multicenter study. Endoscopy 37: 613–616
Heine GDN, Hadithi M, Groenen MJM, Kuipers EJ, Jacobs MAJM, Mulder CJJ (2006) Double-balloon enteroscopy: indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease Endoscopy 38: 42–48
Kuno A, Yamamoto H, Kita H, Sunada K, Yano T, Hayashi Y, Sato H, Miyata T, Sekine Y, Iwamoto M, Ido K, Sugano K (2004) Double-balloon enteroscopy through a Roux-en-Y anastomosis for EMR of an early carcinoma in the efferent duodenal limb. Gastrointest Endosc 60: 1032–1034
Matsumoto T, Esaki M, Moriyama T, Nakamura S, Lida M (2005) Comparison of capsule endoscopy and enteroscopy with double-balloon method in patients with obscure bleeding and polyposis. Endoscopy 37: 827–31
May A, Nachbar L, Wardak A, Yamamoto H, Ell C (2003) Double-balloon enteroscopy: preliminary experience in patients with obscure gastrointestinal bleeding or chronic abdominal pain. Endoscopy 35: 985–991
Monkemuller K, Weight J, Treiber G, Kolfenbach S, Kahl S, Rocken C, Ebert M, Fry LC, Malfertheiner P (2006) Diagnostic and therapeutic impact of double-balloon enteroscopy. Endoscpy 38: 67–72
Nakamura M, Niwa Y, Ohmiya N, Miyahara R, Ohashi A, Itoh A, Hirooka Y, Goto H (2006) Preliminary comparison of capsule endoscopy and double-balloon enteroscopy in patients with suspected small bowel bleeding. Endoscopy 38: 59–66
Sakai P, Kuga R, Safatle-Ribeiro AV, Faintuch J, Gama-Rodrigues JJ, Ishida RK, Furuya CK, Yamamoto H, Ishioka S (2005) Is it feasible to reach the bypassed stomach after Roux-en-Y gastric bypass for morbid obesity? The use of the double-balloon enteroscope. Endoscopy 37: 566–569
Yamamoto H, Kita H, Sunada K, Hayashi Y, Sato H, Yano T, Iwamoto M, Sekine Y, Miyata T, Kuno A, Ajibe H, Ido K, Sugano K (2004) Clinical Outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol 2: 1010–1016
Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, Ido K, Sugano K (2001) Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 53: 216–220
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Safatle-Ribeiro, A.V., Kuga, R., Ishida, R. et al. Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?. Surg Endosc 21, 2231–2236 (2007). https://doi.org/10.1007/s00464-007-9353-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-007-9353-2