Utility of single balloon enteroscopy (SBE) for difficult cases of total colonoscopy

Abstract

Key words: difficult colonoscopy, single balloon enteroscopy, large intestine Abbreviations: BE, balloon enteroscopy; SBE, single balloon enteroscopy; CT, computed tomography Balloon enteroscopy (Be) was originally developed for observation of the deep small intestine, and has recently been utilized for difficult cases of total colonoscopy due to reasons such as adhesions and elongation. In this report, we present our experience with single balloon enteroscopy (sBe) to facilitate successful colonoscopy when standard techniques failed. In two cases, early colon cancers were detected in the cecum by sBe and were removed endoscopically or surgically. a third case is discussed in which sBe was attempted but was ultimately not successful. In that case, total colonoscopy was not performed because of looping in the sigmoid and transverse colon. a fourth case in which sBe was performed in order to remove colonic gas in a patient with megacolon. In that case, total colonoscopy could not be completed because the sBe balloon could not "grab" the dilated colon and therefore could not advance. sBe is a useful adjunct to standard colonoscopy in challenging cases, but has limitations and does not always ensure success.

Advances in balloon endoscopes

“…In 2012, Hotta et al [80] performed DBECS in 110 patients in whom insertion of a colonoscope was difficult, reporting that the rate of insertion to the cecum was 100 % (multicenter/prospective study). Regarding studies on single-balloon endoscopy performed in patients in whom insertion of a colonoscope was difficult, a literature search using 'SBE colonoscopy' as the key word yielded 9 articles [132][133][134][135][136][137][138][139][140][141]. In 2010, Teshima et al [132] performed singleballoon endoscopic colonoscope (SBECS) in 22 patients in whom insertion was difficult, reporting that the rate of insertion to the cecum was 96 %.…”