Enteroscopy-enteroclysis: experience with a combined endoscopic-radiographic technique.
BACKGROUND
Video enteroscopy provides high-quality diagnostic and therapeutic capabilities in the proximal small bowel. Enteroclysis remains an essential diagnostic technique in the distal small bowel. We report our experience with the combination of these techniques.


METHODS
Seventy-one patients with obscure gastrointestinal bleeding (group A, 54 patients) or abnormal radiologic studies (group B, 17 patients) were evaluated with enteroscopy. Enteroclysis via a tube inserted on withdrawal of the enteroscope was performed in all patients with nondiagnostic enteroscopy.


RESULTS
Enteroscopy identified bleeding sites in 29 of 54 (54%) group A patients (12 angiodysplasia, 10 ulcers, 7 gastric erosions, 1 vessel, 1 aortoenteric fistula), and lesions in 11 of 17 (65%) group B patients (7 ulcers, 3 benign strictures, 2 radiation enteritis, 1 mass). In group A, 13 (24%) patients had findings detectable by standard esophagogastroduodenoscopy. Enteroclysis identified masses in 2 of 24 (8%) group A patients, and lesions in 5 of 10 (50%) group B patients (3 strictures, 1 mass, 1 large diverticulum). No complications occurred.


CONCLUSIONS
The combination of enteroscopy and enteroclysis is safe and offers quality small bowel examinations in more comfortable and convenient single diagnostic sittings. This combination detected bleeding sources in 57% and lesions in 70% of patients. Though enteroclysis identified bleeding sources in only 8% of patients, this study excluded lesions other than angiodysplasia.
Willis
J R
JR
Washington University School of Medicine, Saint Louis, Missouri, USA.
Chokshi
H R
HR
Zuckerman
G R
GR
Aliperti
G
G
D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology; D007579:Jejunal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012680:Sensitivity and Specificity