[Application of double balloon enteroscopy in pediatric patients]

Double balloon enteroscopy (DBE) is already an established modality of investigation in adults though its use in children has not yet been widely practiced. This study aimed to explore the method and safety of pediatric DBE and to evaluate its clinical value and applicability in the pediatric age group.

During the period from December, 2006 to October, 2009 DBE was performed on a total of 22 patients (age 4 to 16 years) at the hospital. The indications included: gastrointestinal bleeding, chronic abdominal pain, suspected Crohn's disease and hypoalbuminemia. With the aid of a specially designed overtube, and the alternate inflation and deflation of the balloons at the tip of the endoscope and overtube, the enteroscope was advanced in the small intestine either antegrade or retrograde by telescoping the small intestine along its way. The range of intestine covered, pathology encountered, and tolerability of the examination by the subjects were recorded during the procedure.

A total of 25 DBE's were performed: antegrade in 3 and retrograde in 22. In 3 patients, both antegrade and retrograde enteroscopy was performed. All the procedures were performed under anesthesia. Inclusive of anesthesia and post-procedure recovery, each procedure took approximately 90 to 120 minutes. The pathology was identified in 18 out of 22 patients (81.82%), including: 7 cases of Crohn's disease, 3 of Meckel's diverticulum, combined ileal and colonic polyp in one, intestinal lymphangiectasis in one, amebiasis in one, small intestinal hemorrhage in 3 and non-specific ileitis in 2. No serious complications such as aspiration pneumonia, perforation or hemorrhage occurred and all patients tolerated the procedures well.

DBE is a useful and feasible procedure in the pediatric patients. Young patients can tolerate the procedure well.