Roles of double-balloon endoscopy in the diagnosis and treatment of Crohn's disease: a multicenter experience.
BACKGROUND
Double-balloon endoscopy (DBE) examinations are not yet widely accepted as routine procedures for examining the small bowel of patients with Crohn's disease (CD).


OBJECTIVE
To evaluate the feasibility and usefulness of DBE for CD in tertiary-care hospitals.


METHODS
Between July 2004 and September 2008, 1444 DBE procedures were performed for 704 patients in 6 tertiary-care hospitals. Patient profile, indication, diagnosis and treatment of DBE were evaluated using a multicenter database.


RESULTS
DBE examinations were most frequently performed in 75 patients with CD, corresponding to 10.5% of all the patients examined by DBE. Fifty patients were diagnosed with CD before DBE, while DBE was performed for the diagnosis of 25 new CD patients. Small bowel lesions were often detected even when the terminal ileum was not involved. In the 75 patients, 21 patients were asymptomatic at the time of DBE examinations. Active inflammatory lesions were detected in 51.2% of the CD patients, and were even detected in 33.3% of the asymptomatic CD patients. The treatment was altered in 53.3% of the CD patients after the DBE evaluation. No severe complications were experienced.


CONCLUSIONS
DBE procedures can be safely performed in patients with CD and should be considered for the precise evaluation of and to determine the treatment strategy for CD.
Kondo
Jumpei
J
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 K1 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Iijima
Hideki
H
Abe
Takashi
T
Komori
Masato
M
Hiyama
Satoshi
S
Ito
Toshifumi
T
Nakama
Akihiro
A
Tominaga
Kouhei
K
Kubo
Mitsuhiko
M
Suzuki
Kunio
K
Iwanaga
Yoshihisa
Y
Ebara
Ryoichi
R
Takeda
Akira
A
Tsuji
Shingo
S
Nishida
Tsutomu
T
Tsutsui
Shusaku
S
Tsujii
Masahiko
M
Hayashi
Norio
N
D000328:Adult; D000368:Aged; D002404:Catheterization; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016208:Databases, Factual; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult