Double-balloon enteroscopy in the diagnosis and management of small-bowel diseases

The aim of this study was to investigate the diagnostic yield of double-balloon enteroscopy (DBE) and its impact on subsequent management.

This study is a retrospective analysis of 300 consecutive patients for investigation of small bowel disease that had been suspected by both clinical symptoms and imaging tests. The final management was guided by the results of DBE. Demographic, clinical, procedural and outcome data were collected for analysis.

Among the 300 patients, lesions were found in 213 (70.1%). These lesions were small-intestinal ulcers, Crohn's disease, chronic inflammation, Meckel's diverticulae, angiodysplasia, polyps, ulcerative lipoma and tumor. Ninety-nine of the 115 patients with suspected intestinal hemorrhage were confirmed, with a positive rate of 86.1%. Also confirmed were 60 of the 99 patients with abdominal pain (positive rate of 60.6%); sixteen of 22 patients with chronic diarrhea (positive rate of 72.7%); thirty-three of the 55 patients with abdominal distention or malnutrition (positive rate of 60.0%); and 7 of 9 patients with refractory hypoalbuminemia. Treatment was performed in 2.3% of patients (3 polyps and 2 angiodysplasia).

This large pilot series shows that DBE is a safe and feasible diagnostic and therapeutic tool for suspected or documented small-bowel diseases.