Comparison of double balloon enteroscopy in adults and children.
OBJECTIVE
To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients.


METHODS
The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey between 2009 and 2011 were examined retrospectively. Adult and pediatric patients were compared according to DBE indications, procedure duration, final diagnosis, and complications. DBE procedures were performed in an operating room under general anesthesia by two endoscopists. An oral or anal approach was preferred according to estimated lesion sites. Overnight fasting of at least 6 h prior to the start of the procedure was adequate for preprocedural preparation of oral DBE procedures. Bowel cleansing was performed by oral administration of sennosides A and B solution, 2 mL/kg, and anal saline laxative enema. The patients were followed up for 2 h after the procedure in terms of possible complications.


RESULTS
DBE was performed in 35 patients (5 pediatric and 30 adult). DBE procedures were performed for abdominal pain, chronic diarrhea, bleeding, chronic vomiting, anemia, and postoperative evaluation of anastomosis. Final diagnosis was diffuse gastric angiodysplasia (n = 1); diffuse jejunal angiodysplasia (n = 1); ulceration in the bulbus (n = 1); celiac disease (n = 1); low differentiated metastatic carcinoma (n = 1); Peutz-Jeghers syndrome (n = 1); adenomatous polyp (n = 1) and stricture formation in anastomosis line (n = 1). During postprocedural follow-up, abdominal pain and elevated amylase levels were noted in three patients and one patient developed abdominal perforation.


CONCLUSIONS
With the help of technological improvements, we may use enteroscopy as a safe modality more frequently in younger and smaller children.
Department of Pediatric Gastroenterology, School of Medicine, Gazi University, 06500 Ankara, Turkey.
Odul Egritas
OE
Gurkan
Tarkan
T
Karakan
Ibrahim
I
Dogan
Buket
B
Dalgic
Selahattin
S
Unal
D015746:Abdominal Pain / Q000209:etiology; D000284:Administration, Oral; D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002400:Cathartics / Q000008:administration & dosage; D016009:Chi-Square Distribution; D002648:Child; D058582:Double-Balloon Enteroscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D007416:Intestinal Perforation / Q000209:etiology; D054368:Laxatives / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014421:Turkey
D002400:Cathartics; D054368:Laxatives
Angiodysplasia; Double-balloon enteroscopy; Peutz-Jeghers syndrome; Polyp; Small bowel disease