title: Usefulness of double balloon endoscopy in patients with surgically distorted intestinal anatomy.
abstract: BACKGROUND
  Double balloon endoscopy (DBE) is a new endoscopic method with the capability for complete observation of whole small bowel. This study evaluated the feasibility and usefulness of DBE for the diagnosis and therapy of small bowel diseases in patients with distorted intestinal anatomy by previous surgeries.
  
  
  METHODS
  From January 2005 to August 2007, 15 patients with Roux-en-Y anastomosis underwent DBE in Asan Medical Center. Eight were men and the median age was 57 years (range, 40 to 68 y). Indications of DBE were suspected small bowel bleeding, chronic diarrhea, and recurrent acute pancreatitis. The main outcome measurements included completeness of the observation of afferent loop and DBE findings.
  
  
  RESULTS
  Because 1 patient underwent DBE twice separately owing to recurrent bleeding, a total of 16 cases were analyzed. The observation of afferent loop was complete in 13 (81%) of 16 cases. The overall diagnostic yield of DBE was 69% (11/16). Out of 11 cases in which DBE detected abnormalities, 6 (55%) showed definite lesions and 5 (45%) probable lesions. Of the 11 cases in which abnormalities were found, 7 (64%) showed lesions in afferent loop. Of the 6 cases in which definite lesions were found, 4 (67%) showed lesions in afferent loop. Therapeutic endoscopic procedures were performed in 4 cases, which include argon plasma coagulation, foreign body removal, and endoscopic nasobiliary drainage.
  
  
  CONCLUSIONS
  DBE in patients with distorted intestinal anatomy such as Roux-en-Y anastomosis is a useful tool for the management of small bowel lesions, especially those in the afferent loop.
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.forename: Soon Man
authors.initials: SM
authors.lastname: Yoon
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Do
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D002404:Catheterization; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal; D004867:Equipment Design; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged