Double-balloon enteroscopy in the diagnosis and the management of small-bowel diseases: an initial experience in 40 patients

Kaffes, Arthur J.; Koo, Jenn Hian; Meredith, Christopher S.

doi:10.1016/j.gie.2005.09.017

Cited by 62 publications

(43 citation statements)

References 25 publications

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“…The diagnostic yield of double-balloon enteroscopy for suspected small bowel disease, particularly in the case of obscure gastrointestinal bleeding, is 72%-80% in the literature [15][16][17][18][19][20]. In the present series, lesions potentially responsible for gastrointestinal bleeding of obscure origin were found in 75% of the patients undergoing double-balloon enteroscopy.…”

Section: Discussionmentioning

confidence: 48%

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The Outcome Assessment of Double-Balloon Enteroscopy for Diagnosing and Managing Patients with Obscure Gastrointestinal Bleeding

Hsu

Chiu

et al. 2006

Dig Dis Sci

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Diagnosing and treating patients with obscure gastrointestinal bleeding is clinically challenging. Most lesions responsible for the origin of obscure gastrointestinal bleeding are located in the small bowel. Double-balloon enteroscopy is a novel method for exploring the small intestine and has significant therapeutic potential. This study evaluated the value of double-balloon enteroscopy in diagnosing and managing obscure gastrointestinal bleeding. From October 2003 to January 2006, a total of 20 patients (6 men, 14 women; mean age, 55.2 years old) with obscure gastrointestinal bleeding (18 obscure overt bleeding, 2 obscure occult bleeding) were investigated by double-balloon enteroscopy. A total of 29 procedures (15 via oral approach and 14 via rectal approach) were performed. The diagnostic yield, endoscopic therapeutic procedures, complications, and outcome were then assessed. Small bowel lesions potentially responsible for the bleeding were identified in 15 (75%) of 20 patients, including 9 angiodysplasias, 2 gastrointestinal stromal tumors (GISTs), 2 ulcers, 1 jejunal granulation polyp, and 1 Peutz-Jeghers polyposis. Endoscopic treatments including heater probe coagulation, polypectomy, and endoscopic mucosal resection were performed in 11 patients. Two patients with GISTs received surgical intervention. Two patients with angiodysplasias that endoscopic treatment failed underwent laparoscopic resections following tattooing. There were no complications and the procedures were tolerated well. Among the 15 patients who had a lesion identified with subsequent treatment, rebleeding occurred in 3 (20%) patients with angiodysplasias. Of the five patients in whom no definite lesion was detected, rebleeding developed in four (80%). For patients with an identified lesion that was further treated, the rebleeding rate was lower than for those with "persistent" obscure gastrointestinal bleeding (P=0.031). We conclude that double-balloon enteroscopy offers a safe and effective method for diagnosing and managing patients with obscure gastrointestinal bleeding.

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Section: Discussionmentioning

confidence: 48%

“…Double-balloon enteroscopy overcomes the limitation of capsule endoscopy and, in particular, can carry out endoscopic intervention [15][16][17][18][19][20]. This study performed therapeutic procedures in 11 patients (55%), mainly heater probe coagulation with or without prior injection, and endoscopic biopsies in 4 patients(20%).…”

Section: Discussionmentioning

confidence: 99%

The Outcome Assessment of Double-Balloon Enteroscopy for Diagnosing and Managing Patients with Obscure Gastrointestinal Bleeding

Hsu

Chiu

et al. 2006

Dig Dis Sci

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“…CE is commonly used prior to DBE, but eight patients diagnosed to have GIST after DBE were reported to have normal CEs. In favor of this, it was previously reported in some relatively small studies that lesions smaller than 3 cm could be overlooked during CE (7,(22)(23)(24). For this reason, we think that ongoing symptoms despite a negative CE should be regarded as an indication for subsequent DBE.…”

Section: Discussionmentioning

confidence: 97%

Double-balloon enteroscopy: The diagnosis and management of small bowel diseases

Pata

Akyüz²,

Erzın³

et al. 2010

Turk J Gastroenterol

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“…Diagnostic yield ranges in the literature from 43 to 80% [4-7, 15-17, 19, 25-28] . The main indications for DBE are obscure gastrointestinal bleeding and suspected Crohn's disease [4][5][6][7] . However, as shown in our series, investigation of polyposis and tumors is another important indication for DBE [31][32][33] .…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Endoscopy Using the Double-Balloon Technique: Four-Year Results in a Tertiary Referral Hospital in Brazil

Kuga¹,

Safatle‐Ribeiro²,

Ishida³

et al. 2008

Dig Dis

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Background: Double-balloon enteroscopy (DBE) allows evaluation and therapy for various small bowel diseases. In this series the outcome of a 4-year experience in a tertiary hospital school in Brazil is reported. Methods: A total of 457 consecutive DBE were performed in 418 patients from August 2004 to August 2008. 93 patients with several indications, whose aim was not the evaluation of suspected diseases of the small bowel mucosa, were excluded, therefore leaving 364 DBE in 325 patients for analysis. Data were retrospectively collected with regard to clinical, endoscopic findings, therapy and complications. Results: Among the 364 DBE performed in 325 patients, 143/325 were males (44%) and 182/325 females (56%) with a mean age of 48.6 ± 15.7 years (range 17–89). Mean investigation time was 64 ± 22 min (range 35–135). The depth of insertion beyond the ligament of Treitz was 230 ± 85 cm (range 30–500) by the antegrade approach and 140 ± 75 cm (range 0–320) by the retrograde approach. Total enteroscopy was achieved in 41.66% of the attempts (30 of 72 patients). Overall diagnostic yield was 54.95% (200 of 364 procedures) ranging from 0 to 100% in this series, depending on the indication. Angiodysplasia was the main diagnosis in 24.5% (49 of 200 procedures) and endoscopic treatment, including biopsies, hemostasis, tattooing and polypectomy were performed in 65.38% (238 of 364 procedures). No major complications were reported. Conclusions: DBE is a feasible, safe and well-tolerated procedure allowing endoscopic therapy. Selection of indications increases its diagnostic yield.

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Double-balloon enteroscopy in the diagnosis and the management of small-bowel diseases: an initial experience in 40 patients

Cited by 62 publications

References 25 publications

The Outcome Assessment of Double-Balloon Enteroscopy for Diagnosing and Managing Patients with Obscure Gastrointestinal Bleeding

The Outcome Assessment of Double-Balloon Enteroscopy for Diagnosing and Managing Patients with Obscure Gastrointestinal Bleeding

Double-balloon enteroscopy: The diagnosis and management of small bowel diseases

Small Bowel Endoscopy Using the Double-Balloon Technique: Four-Year Results in a Tertiary Referral Hospital in Brazil

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