Push enteroscopy in the era of capsule endoscopy

Area of Science:

• Gastroenterology
• Endoscopy
• Diagnostic Yield

Background:

• Capsule endoscopy (CE) has prompted a reevaluation of the role of push enteroscopy (PE).
• Understanding the diagnostic utility of PE in the current endoscopic landscape is crucial.

Purpose of the Study:

• To assess the diagnostic yield of push enteroscopy (PE) based on specific indications.
• To compare the diagnostic yield of PE in patients pre-treated with capsule endoscopy (CE) versus CE-naïve patients.

Main Methods:

• A retrospective analysis of 155 patients who underwent PE between January 2002 and May 2006.
• Indications included iron deficiency anemia, overt bleeding, suspected/refractory celiac disease, and Crohn's disease assessment.
• Diagnostic yield was compared between patients who had prior CE and those who were CE-naïve.

Main Results:

• The overall diagnostic yield for PE was 30%, with the highest yield observed in cases of overt bleeding (P<0.001).
• In 74 patients, both PE and CE were performed; the diagnostic yield was 41% for CE-followed-by-PE versus 47% for CE-naïve patients (P<1).
• No lesions detected by PE were missed by prior CE.

Conclusions:

• Push enteroscopy (PE) demonstrates the highest diagnostic yield for overt small bowel bleeding.
• PE is recommended as an adjuvant to capsule endoscopy (CE) for facilitating therapeutic interventions.