title: Double-balloon enteroscopy: the diagnosis and management of small bowel diseases.
abstract: OBJECTIVE
  Double-balloon enteroscopy is a novel endoscopic technique developed to investigate small bowel diseases. The aim of this study was to evaluate the diagnostic and therapeutic impact of double-balloon enteroscopy in patients with suspected or documented small bowel disease who were referred to our tertiary center, which was the first to introduce the double-balloon enteroscopy system in Turkey.
  
  
  METHODS
  This is a single-center prospective study. A total of 216 double-balloon enteroscopy procedures (168 antegrade, 48 retrograde) were done in 188 patients who were referred to our center for suspected small bowel disease. The main outcome measurements were complications, insertion depth and duration, and diagnostic and therapeutic rates.
  
  
  RESULTS
  Indications included obscure gastrointestinal system bleeding, iron deficiency anemia, abnormality on radiographic evaluation, abdominal pain, diarrhea, and suspected celiac disease. A diagnosis was established in 130 (69%) patients. The most common pathologic findings included angiodysplasias (29%), ulcerations (16%) and Crohn's disease (9%). Mean time±standard deviation to perform the examination using the antegrade route was 116.4±7.17 min, and the average±standard deviation insertion length was 310.65±90.3 cm (beyond the pylorus). Therapeutic interventions were performed in 66 patients (56 angiodysplasias, 4 ulcers, 4 strictures, and 2 polyps), and the success rate was 97%. No serious complication was observed, although pancreatitis occurred in 6 of 48 (12.5%) patients who were followed up for post-procedure pancreatic enzyme levels.
  
  
  CONCLUSIONS
  Our prospective analysis suggests that double-balloon enteroscopy is a feasible and useful technique for the diagnosis as well as treatment of small intestinal disorders.
authors.affiliation: Department of Gastroenterology, Yeditepe University, School of Medicine, İstanbul. cenpata@yahoo.com
authors.forename: Cengiz
authors.initials: C
authors.lastname: Pata
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Akyüz
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Erzın
authors.forename: Arzu
authors.initials: A
authors.lastname: Mercan
mesh_terms: D015746:Abdominal Pain / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000473:pathology / Q000628:therapy; D016888:Angiodysplasia / Q000473:pathology / Q000628:therapy; D002446:Celiac Disease / Q000473:pathology / Q000628:therapy; D003424:Crohn Disease / Q000473:pathology / Q000628:therapy; D003967:Diarrhea / Q000473:pathology / Q000628:therapy; D058582:Double-Balloon Enteroscopy; D004381:Duodenal Ulcer / Q000473:pathology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000628:therapy; D006801:Humans; D007410:Intestinal Diseases / Q000473:pathology* / Q000628:therapy*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies