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


METHODS
DBE was performed via the mouth, anus, or both approaches to diagnose small-intestinal disease.


METHODS
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.


CONCLUSIONS
DBE is effective and safe for the diagnosis of small-intestine disease in a Chinese patient cohort.
Zhi
Fa-chao
FC
Institute of Digestive Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Yue
Hui
H
Jiang
Bo
B
Xu
Zhi-min
ZM
Bai
Yang
Y
Xiao
Bing
B
Zhou
Dian-yuan
DY
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002681:China; D015331:Cohort Studies; D003967:Diarrhea / Q000209:etiology; D020776:Endoscopes, Gastrointestinal; D004867:Equipment Design; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology; D007410:Intestinal Diseases / Q000175:diagnosis*; D007414:Intestinal Neoplasms / Q000175:diagnosis; D007421:Intestine, Small; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008875:Middle Aged; D012680:Sensitivity and Specificity