[Endoscopic study of the small intestine with push enteroscopy. A prospective study].
OBJECTIVE
To evaluate whether push enteroscopy of the small bowel (PES), undertaken after extensive previous investigations in suspected intestinal bleeding from an uncertain site, chronic diarrhoea or lymphoma of the small intestine, contributes to the diagnosis, and to ascertain the results of PES and its clinical significance.


METHODS
56 consecutive patients (29 men, 27 women; mean age 63 years) were investigated prospectively. The main indications for PES were the search for the source of intestinal bleeding in 79% of patients (group A), chronic diarrhoea or tropical sprue in 16% (group B) and search for tumour of lymphoma in 5% (group C). PES was always performed in fasting patients under sedation/analgesia using a video PES, which contrary to catheter enteroscopy provides a channel for intervention.


RESULTS
In group A 27% of patients were found to have lesions, in particular angiodysplasias, or (in once case) leiomyoma. Half of these patients were successfully treated endoscopically without later surgical intervention being required (mean follow-up of six months). In the other half operation became necessary, either because the disease itself indicated it or the bleeding persisted, the source being in the more distant small intestine and thus not accessible to endoscopic intervention: only 50% of the length of the small intestine proved to be within reach of the instrument. No abnormalities were discovered in patients of groups B and C.


CONCLUSIONS
In cases of gastrointestinal bleeding from an uncertain source PES should be performed first, because in many cases it may obviate surgical intervention. But PES seems to contribute little of diagnostic value in other indications.
Benz
C
C
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen am Rhein gGmbH.
Martin
W R
WR
Arnold
J
J
Jakobs
R
R
Riemann
J F
JF
D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000175:diagnosis; D003967:Diarrhea / Q000175:diagnosis; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D007430:Intraoperative Care / Q000379:methods; D008223:Lymphoma / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014741:Video Recording
Die endoskopische Untersuchung des Dünndarms mit Push-Enteroskopie. Eine prospektive Untersuchung.