A retrospective study of the application on double-balloon enteroscopy in 378 patients with suspected small-bowel...

The diagnostic yield of double-balloon enteroscopy (DBE) is variable, depending on the indication for the investigaton. The aim of this study was to investigate the diagnostic yield of DBE, and impact on subsequent management.

A total of 378 patients with obscure gastrointestinal bleeding, abdominal pain, diarrhea, or small-bowel obstruction were included in this retrospective study. DBE procedures were followed by active treatments, symptomatic treatments, or follow-up without any treatment. A special scoring system was designed for evaluating the severity of gastrointestinal bleeding, and the scores were compared before and after DBE examination.

Lesions were detected in 247/378 patients (65.3%). The diagnostic yields were 80.6% for obscure gastrointestinal bleeding, 37.7% for abdominal pain, 36.5% for diarrhea, and 81.3% for small-bowel obstruction. In 208/247 patients with a confirmed diagnosis (84.2%), specific treatments were performed. Symptoms disappeared or improved in 190/208 patients (91.3%). The mean score (+/- standard deviation) for the severity of gastrointestinal bleeding in the 154 patients with positive findings before DBE was 6.8 +/- 2.2, and this dropped to 1.5 +/- 0.5 ( P < 0.01) in patients who underwent specific treatments, to 3.6 +/- 0.7 ( P < 0.05) in patients who received symptomatic relief, and to 3.9 +/- 0.9 ( P < 0.05) in patients who received no treatment.

Double-balloon enteroscopy had high diagnostic yield in patients with obscure gastrointestinal bleeding and obstruction. The results of DBE had a substantial impact on subsequent management decisions.