Double balloon enteroscopy in pediatrics: Evaluation of midgut pathologies at a national medical center

Double balloon enteroscopy is used for the diagnosis and treatment of diseases of the small bowel. It is a less invasive means for carrying out a therapeutic intervention, compared with surgical alternatives. Experience with double balloon enteroscopy in pediatrics is in the early stages of development. We believe the performance of this procedure in children has a significant clinical impact on therapeutic decision-making in diseases of the small bowel. Our aim was to evaluate double balloon enteroscopy in children for the diagnosis and treatment of midgut pathologies.

A retrospective, descriptive, and observational study was conducted.

Twenty procedures were performed on patients whose ages ranged from 6 to 17 years, with a mean of 13.3 years. The most frequent indication for doble balloon enteroscopy was gastrointestinal bleeding suspected to originate from the small bowel. Double balloon enteroscopy resulted in an overall diagnostic yield of 65% and an endoscopic therapeutic yield of 25%. Endoscopic therapy was performed in 4 patients (anastomosis rehabilitation through cutting, sclerosis of vascular lesion with 1.5% polidocanol, polypectomy, biliary stent removal). No patient underwent surgical treatment after double balloon enteroscopy. Therapeutic yield, in general, including endoscopic and medical treatment, was 55%.

We consider double balloon enteroscopy in pediatric patients a feasible procedure, offering good results with minor complications and directly contributing to medical and/or endoscopic decision-making.