Effect of Double-Balloon Enteroscopy on Diagnosis and Treatment of Small-Bowel Diseases

Chin Med J (Engl). 2018 Jun 5;131(11):1321-1326. doi: 10.4103/0366-6999.232802.

Abstract

Background: The diagnosis and treatment of small-bowel diseases is clinically difficult. The purpose of this study was to evaluate the diagnostic and therapeutic value of double-balloon enteroscopy in small-bowel diseases.

Methods: The history and outcomes of 2806 patients who underwent double-balloon enteroscopy from July 2004 to April 2017 were reviewed, which included 562 patients with obscure digestive tract bleeding, 457 patients with obscure diarrhea, 930 patients with obscure abdominal pain, 795 patients with obscure weight loss, and 62 patients with obscure intestinal obstruction. Examinations were performed through the mouth and/or anus according to the clinical symptoms and abdominal images. If a lesion was not detected through one direction, examination through the other direction was performed as necessary. Eighty-four patients with small-bowel polyps, 26 with intestinal obstruction caused by enterolith, and 18 with bleeding from Dieulafoy's lesions in the small intestine were treated endoscopically.

Results: A total of 2806 patients underwent double-balloon enteroscopy, and no serious complications occurred. An endoscopic approach through both the mouth and anus was used in 212 patients. Lesions were detected in 1696 patients, with a detection rate of 60.4%; the rates for obscure digestive tract bleeding, diarrhea, abdominal pain, weight loss, and intestinal obstruction were 85.9% (483/562), 73.5% (336/457), 48.2% (448/930), 49.1% (390/795), and 62.9% (39/62), respectively. For patients with small-bowel polyps who underwent endoscopic therapy, no complications such as digestive tract bleeding and perforation occurred. Intestinal obstruction with enteroliths was relieved with endoscopic lithotripsy. Among the 18 patients with bleeding from small-bowel Dieulafoy's lesions, 14 patients were controlled with endoscopic hemostasis.

Conclusion: Double-balloon enteroscopy is useful for diagnosing and treating some small-bowel disease.

双气囊小肠镜对小肠疾病诊治的研究摘要摘要背景: 临床上小肠疾病的诊断和治疗困难,本研究的目的是评价双气囊小肠镜在小肠疾病诊治中的价值。 方法: 分析2004年7月至2017年4月2806例患者双气囊小肠镜检查及治疗的临床资料,不明原因的消化道出血562例、腹泻457例、腹痛930例、消瘦795例、小肠梗阻62例。进镜方式分为经口及经肛两种,根据临床症状及影像学检查结果决定首选进镜方式(经口/经肛),经一侧检查后未发现病灶者,对疾病诊断不明确的病例择期改换另一侧进镜方式再行检查。小肠息肉84例,小肠粪石并发肠梗阻26例,小肠Dieulafoy病出血18例,分别采用内镜下息肉切除术、内镜下碎石术、内镜下止血术治疗。 结果: 2806例患者接受双气囊小肠镜检查,所有患者未出现严重不良反应及并发症,耐受性尚好。212例患者接受双侧进镜,有阳性发现1696例,病变检出率为60.4%;对不明原因消化道出血患者病变检出率为85.9%(483/562);对不明原因腹泻的病变检出率为73.5%(336/457);对不明原因腹痛的检出率较低为48.2%(448/930);对不明原因消瘦的检出率为49.1%(390/795);对小肠梗阻的病变检出率为62.9%(39/62)。小肠息肉行内镜下切除后未发生消化道出血、穿孔等并发症;小肠粪石并肠梗阻经内镜下碎石后肠梗阻解除;18例小肠Dieulafoy病出血行内镜下止血治疗后14例出血停止。 结论: 双气囊小肠镜对小肠疾病的诊治有重要价值。.

Keywords: Diagnosis; Double-Balloon Enteroscopy; Small Bowel; Therapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Double-Balloon Enteroscopy / methods*
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Intestinal Diseases / diagnosis*
  • Intestinal Diseases / surgery
  • Intestinal Obstruction
  • Intestine, Small / diagnostic imaging*
  • Leiomyosarcoma / diagnosis
  • Leiomyosarcoma / surgery
  • Lymphoma / diagnosis
  • Lymphoma / surgery
  • Male
  • Middle Aged
  • Polyps / diagnosis
  • Polyps / surgery
  • Young Adult