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Background/Aims: Double-balloon enteroscopy (DBE) allows for the diagnoses and treatment of small bowel tumors (SBTs). This study aimed to evaluate the utility of DBE for the diagnosis and treatment of SBTs.Methods: Patients diagnosed with SBTs who underwent DBE were included in this study. According to their endoscopic appearances, they were categorized as polyps or masses, and according to their histological characteristics, they were categorized as benign or malignant SBTs.Results: A total of 704 patients were retrospectively analyzed, and 90 (12.8%) were diagnosed with SBTs. According to their endoscopic appearance, 48 (53.3%) had polyps and 42 (46.7%) had masses. Additionally, 53 (58.9%) and 37 (41.1%) patients had malignant and benign SBTs, respectively, depending on their histological characteristics. Patients diagnosed with polyps were younger than those diagnosed with masses (p<0.001). Patients diagnosed with benign SBTs were younger than those diagnosed with malignant SBT (p<0.001). Overall, histological diagnosis was determined using DBE in 73 (81.1%) patients.Conclusions: DBE is a useful method for diagnosing SBTs. Additionally, the histological type of the lesion can be determined using DBE.

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Peutz-Jeghers syndrome is an autosomal dominant disorder characterised by multiple hamartomatous polyps and muco-cutaneous pigmentation. Most polyps are found in the small intestine, especially in the jejunum. Enteroscopy with polypectomy is a reliable method to prevent polyp-related complications. A pregnant woman, who was diagnosed as a case of Peutz-Jeghers syndrome with a history of intestinal resection, was admitted to our clinic. Termination was recommended to the patient due to the possibility of polyps, causing obstruction during pregnancy. She underwent double balloon enteroscopy in the second trimester. Large polyps that could cause intussusception were removed and post-polypectomy bleeding was successfully controlled. This procedure was the first double balloon enteroscopy during pregnancy, reported in the literature. The procedure should be performed by experienced endoscopists, who can cope well with the complications in expert centres, as the procedure carries a high risk.

A 65-year-old man presented to the outpatient department with a complaint of moderate flatulence for 2 years. His personal history included coronary artery disease and type 2 diabetes mellitus, which was poorly controlled by oral antidiabetic medications. He also underwent inguinal hernia operation 2 years previously. Physical examination revealed no pathologic signs. Vital signs were within normal limits. Laboratory tests showed no abnormal values except high fasting blood sugar level. After colonic preparation with polyethylene glycol solution, colonoscopy was performed. The sigmoid colon contained multiple polypoid cystic structures (▶ Fig. 1). The colonic section with these extensive lesions was filled with water. Polypoid cystic structures were punctured using a sclerotherapy needle under water. The emergence of gas bubbles from punctured sites was seen (▶ Fig. 2, ▶ Video 1). Preliminary diagnosis of pneumatosis intestinalis was considered. Subsequent computed tomography revealed intramural gas collections in the wall of the sigmoid colon. In etiological investigation tests, chest X-ray and respiratory function tests were normal. Antinuclear antibodies and extractable nuclear antigen antibodies were found to be nonreactive. Direct examination, culture, and parasite tests of stool were negative. Rapid Detection of Clostridium difficile in feces by real-time polymerase chain reaction turned out to be negative too. There was no pathology on upper gastrointestinal endoscopy. Test for human immunodeficiency virus was negative. Hence, we considered our case to be idiopathic. Pneumatosis intestinalis is a rare disease, the clinic symptoms of which may be asymptomatic or serious enough to be a case of acute abdomen. Depending on different etiologies, it can occur in two forms -primary (idiopathic) or secondary. Diagnosis is often made with radiologic or endoscopic imaging. We presented a case that was diagnosed endoscopically with water-immersion technique and puncture. E267This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.