Diagnostic value of double balloon enteroscopy for small-intestinal disease: experience from China

• Published in: Gastrointestinal endoscopy 2007-09, Vol.66 (3), p.S19-S21
• Main Authors: Zhi, Fa-chao, MD, Yue, Hui, MD, Jiang, Bo, MD, Xu, Zhi-min, MD, Bai, Yang, MD, Xiao, Bing, MD, Zhou, Dian-yuan, MD
• Format: Article
• Language: English
• Subjects: Abdominal Pain - etiology; Adolescent; Adult; Aged; Biological and medical sciences; Child; China; Cohort Studies; Diarrhea - etiology; Digestive system. Abdomen; Endoscopes, Gastrointestinal; Endoscopy; Equipment Design; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Hemorrhage - etiology; Humans; Hypoalbuminemia - etiology; Intestinal Diseases - diagnosis; Intestinal Neoplasms - diagnosis; Intestine, Small; Investigative techniques, diagnostic techniques (general aspects); Male; Malnutrition - etiology; Medical sciences; Metabolic diseases; Middle Aged; Other diseases. Semiology; Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...); Sensitivity and Specificity; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2007.03.1047

Background Diseases of the small intestine include, among others, ulceration, chronic inflammation, Meckel's diverticula, vascular deformities, and cancer. Objective To study the diagnostic value of double balloon enteroscopy (DBE) for small-intestinal disease in a Chinese patient cohort. Design DBE was performed via the mouth, anus, or both approaches to diagnose small-intestinal disease. Patients We studied 155 patients with clinically suspected small-intestinal disease: 110 men and 45 women. Their age ranged from 6 to 75 (mean 41). There were 92 cases with small-intestinal hemorrhage, 39 with abdominal pain, 7 with diarrhea, 13 with abdominal distention, 3 cases with malnutrition, and 1 with diarrhea and refractory hypoalbuminemia. Results Among the 155 patients, lesions were found in 126 (81.3%). These lesions found were small-intestinal ulcers (including Crohn's disease), chronic inflammation, Meckel's diverticulae, vascular deformities, and carcinoma. Eighty-five of the 92 patients with suspected intestinal hemorrhage were confirmed, with a positive rate of 92.4%. Also confirmed were 24 of the 39 patients with abdominal pain (positive rate of 61.5%); 16 of the 23 patients with diarrhea, abdominal distention, or malnutrition (positive rate of 69.6%); and 1 patient with refractory hypoalbuminemia. Among the 126 patients with positive findings, the lesions were located in the small intestine in 116 patients, in the stomach and duodenum in 9 patients, and in the colon in 1 patient. In the 45 patients with small-intestinal ulcer, 29 patients had recurrent hemorrhage, 9 had abdominal pain, 4 had abdominal distention, 2 had malnutrition, and 1 had diarrhea. Ulcers were located in the jejunum in 20 patients, in the ileum in 20 patients, and in both the jejunum and ileum in 5 patients. For 7 patients with small-intestinal ulceration diagnosed as Crohn's disease, the concordance rate of diagnosis between preoperative and postoperative diagnosis was 57.1%, lower than other diseases ( P < .01). One patient had a perforation. Conclusion DBE is effective and safe for the diagnosis of small-intestine disease in a Chinese patient cohort.