title: Use of a double balloon enteroscope facilitates caecal intubation after incomplete colonoscopy with a standard colonoscope.
abstract: BACKGROUND
  Caecal intubation is a necessary step in the complete endoscopic evaluation of the colon. Studies have estimated that experienced colonoscopists may fail to reach the caecum in up to 10% of cases.
  
  
  OBJECTIVE
  To evaluate the utility of the double balloon enteroscope used for complete examination of the colon in patients with incomplete standard colonoscopy.
  
  
  METHODS
  Twenty consecutive patients with incomplete colonoscopies within the Veterans Affairs Palo Alto Health Care System. Mean age of 66 years (S.D.+/-12 years, range 46-84), 16 men.
  
  
  METHODS
  Prospective single-centre case series on the caecal intubation rate using standard double balloon enteroscope technique in patients with previous incomplete conventional colonoscopy.
  
  
  RESULTS
  Use of the standard double balloon enteroscope technique permitted complete colonoscopy to be achieved in 95% of the patients (19/20). Seven patients (35%) had significant pathology beyond the extent of the prior incomplete colonoscopy. We performed endoscopic mucosal resection, polypectomy or biopsy. The mean time to reach the caecum was 28 min (S.D.+/-20 min, range 6-90 min). The sedation was similar to conventional colonoscopy. No complications occurred.
  
  
  CONCLUSIONS
  The double balloon enteroscope technology and technique can be used to complete examination of the colon in patients who were referred because of incomplete standard colonoscopy.
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Stanford University School of Medicine, 3801 Miranda Avenue, GI 111, Palo Alto, CA 94305, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kaltenbach
authors.forename: R
authors.initials: R
authors.lastname: Soetikno
authors.forename: S
authors.initials: S
authors.lastname: Friedland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002432:Cecum / Q000601:surgery; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged