[Utility of single- and double-balloon enteroscopy]

Area of Science:

• Gastroenterology
• Endoscopy

Context:

• Small bowel examination is challenging due to its length and inaccessibility.
• Enteroscopy, particularly with balloon-assisted techniques, offers a method for visualizing and intervening in the small intestine.

Purpose:

• To evaluate the efficacy, indications, and complications of single- and double-balloon enteroscopy for small bowel examination.
• To assess the diagnostic and therapeutic utility of enteroscopy in various gastrointestinal conditions.

Summary:

• Both single- and double-balloon enteroscopes demonstrate similar efficacy for small bowel examination.
• Complete oral examination is feasible in 25-40% of patients within 60-90 minutes; combined oral and rectal routes achieve 75% complete visualization.
• Indications include obscure gastrointestinal bleeding, tumors, Crohn's disease, obstruction, malabsorption, and therapeutic interventions like foreign body retrieval, dilatation, and enteral tube placement.
• Hemostatic efficacy is high for significant bleeding, but polypectomy efficacy/risk compared to colonoscopy is not well-established.
• Complications such as pancreatitis and perforation occur at rates of 0.34% and 0.34-6.4%, respectively.
• The overall level of evidence for most indications is low due to limited prospective studies.

Impact:

• Enteroscopy provides a valuable tool for diagnosing and treating conditions within the small bowel, particularly obscure gastrointestinal bleeding.
• The procedure aids in therapeutic interventions and enteral feeding tube placement, improving patient management.
• Further high-quality research is needed to strengthen the evidence base for enteroscopy indications and optimize its risk-benefit profile.