Double-balloon enteroscopy for the diagnosis and treatment of obscure bleeding, inflammatory bowel diseases and polyposis syndromes: we see more but do we know more?
OBJECTIVE
Our aim was to report our experience with the Fujinon EN-450 T5 therapeutic double-balloon endoscope (DBE) in the diagnosis of small bowel diseases.


METHODS
Between August 2005 and October 2006, 52 DBE procedures were conducted on 47 consecutive patients (M/F: 22/25, age: 51.6 SD 19.5 years) presenting at our tertiary referral hospital (35 and 7 patients from oral and anal route, respectively; 5 patients from both). All procedures were performed using i.v. anesthesia, at our outpatient clinic.


RESULTS
Indication suspected small-bowel bleeding in 28 patients, suspected/known inflammatory bowel syndrome (IBD) in 12 and polyposis/suspected neoplasia in 7. In obscure bleeding small-bowel abnormality was found in 18 patients (64.3%) including angiodysplasias/erosions and one polypoid lesion. In suspected IBD, IBD was diagnosed in 2 out of 8 cases. In patients with polyposis syndromes, polyps were in two Peutz-Jeghers patients, while a further patient with suspected stenosis was diagnosed with primary adenocarcinoma. The average insertion length was app. 213cm. No severe complications were observed.


CONCLUSIONS
Based on our experience DBE is a safe and useful method for evaluating and treating small bowel disease in selected patients with obscure bleeding, IBD or polyposis syndromes, however the clinical importance of minute lesions still needs to be determined.
1st Department of Medicine, Semmelweis University, Budapest, Hungary. kislakpet@bel1.sote.hu
Peter Laszlo
PL
Lakatos
Peter
P
Fuszek
Henrik Csaba
HC
Horvath
Laszlo
L
Zubek
Petra
P
Haller
Janos
J
Papp
D000368:Aged; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000601:surgery; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000601:surgery*; D044483:Intestinal Polyposis / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged