title: Preliminary colonoscopy facilitates retrograde double-balloon enteroscopy.
abstract: OBJECTIVE
  Retrograde double-balloon enteroscopy (RDBE) has a high failure rate due to difficulty intubating the ileo-cecal (IC) valve. We examined the utility of a pre-RDBE colonoscopy using a pediatric colonoscope to clean the cecum and perform an initial intubation of the IC valve.
  
  
  METHODS
  This study is a retrospective review of RDBE procedures for 45 patients at a single tertiary-care center to examine the success of IC intubation, maximal depth of enteroscope insertion, and duration of the procedure.
  
  
  RESULTS
  The IC intubation success rate among patients who underwent RDBE using this novel method was 100 % as compared to 72.7 % using the traditional method (P < 0.003).
  
  
  CONCLUSIONS
  RDBE preceded by colonoscopy had a significantly higher IC intubation success rate, compared to RDBEs performed using the traditional method. RESULTS support the use of this novel method when IC valve intubation using standard methods is difficult, and it may limit the need for repeat procedures or the use of other modalities for examining the small bowel.
authors.affiliation: Department of Internal Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 USA.
authors.forename: Kanishka
authors.initials: K
authors.lastname: Bhattacharya
authors.affiliation: Department of Internal Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Cave