Status evaluation: enteroscopy

Enteroscopy is a method to examine the small bowel mucosa beyond the reach of standard upper endoscopes. In practice it has primarily been used to search for a bleeding lesion in patients where one is not detected by conventional means. Such patients constitute only a small percentage of those who bleed (15,20). Experience is greatest with push enteroscopy. Examination of the distal duodenum and proximal jejunum using a standard or pediatric colonoscope is practical, appears to be safe and provides a satisfactory diagnostic and therapeutic yield in experienced hands. Longer designated push enteroscopes are under investigation. Sonde type enteroscopes can be passed to the ileum in most cases. A cause for bleeding can be detected in approximately one-quarter to one-third of individuals with minimal morbidity. Certain technical problems limit their efficacy and their role in the evaluation of patients with bleeding has not yet been clearly defined.