title: Double-Balloon Endoscopy in Overt and Occult Small Bowel Bleeding: Results, Complications, and Correlation with Prior Videocapsule Endoscopy in a Tertiary Referral Center.
abstract: OBJECTIVE
  Videocapsule endoscopy (VCE) and double-balloon endoscopy (DBE) allow deep exploration in patients with suspected small bowel pathology. VCE is often performed as an initial small bowel examination to explore whether an intervention by DBE is indicated and to determine insertion route. The study aim was to evaluate the correlation between DBE and VCE in patients with obscure or overt bleeding or anemia, as well as intervention frequency, and complications.
  
  
  METHODS
  Retrospective observational study.
  
  
  RESULTS
  DBE procedures (n=205) showed small bowel lesions in 64% cases. Antegrade DBE showed positive results in 79% cases, mostly angiodysplasias (63%). Retrograde DBE showed positive results in 22% cases. An intervention was performed in 64% of DBE procedures. The major complication rate was 0.5%, which was one case of perforation. Pancreatitis did not occur. The overall diagnostic agreement was 66% among the 134 DBEs with preceded VCE.
  
  
  CONCLUSIONS
  In cases of overt or occult bleeding or anemia, DBE was positive in 64%, with only a few complications. Positive correlation was 66% among initially performed VCEs and DBEs. Owing to the time-consuming and invasive character of DBE, performing VCE before DBE might still be clinically relevant.
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Ziekenhuis, Eindhoven, Netherlands.
authors.forename: Carlijn
authors.initials: C
authors.lastname: Hermans
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Ziekenhuis, Eindhoven, Netherlands.
authors.forename: Arnold
authors.initials: A
authors.lastname: Stronkhorst
authors.affiliation: Department of Gastroenterology and Hepatology, Elkerliek Ziekenhuis, Helmond, Netherlands.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Tjhie-Wensing
authors.affiliation: Department of Gastroenterology and Hepatology, Máxima Medisch Centrum, Veldhoven, Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Kamphuis
authors.affiliation: Department of Gastroenterology and Hepatology, Bernhoven Ziekenhuis, Uden, Netherlands.
authors.forename: Bas van
authors.initials: BV
authors.lastname: Balkom
authors.affiliation: Department of Gastroenterology and Hepatology, Sint Jans Gasthuis, Weert, Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Dahlmans
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Ziekenhuis, Eindhoven, Netherlands.
authors.forename: Lennard
authors.initials: L
authors.lastname: Gilissen
keywords: Anemia; Capsule endoscopy; Double-balloon endoscopy; Hemorrhage; Intestine, small