Double-balloon Enteroscopy Shows Potential Benefits In Children

Erdman, MD, gastroenterologist and at Nationwide Children's Hospital and one of the study authors. Yet, even with this progress, endoscopic examination and treatment in the small intestine has remained a challenge, especially in children. "Small intestinal enteroscopy in the pediatric population remains relatively unknown and underutilized," said Dr. Erdman, also a professor of Clinical Pediatrics at The Ohio State University College of Medicine. To shed light on the indications and possible benefits of DBE in children, physicians from Nationwide Children's reviewed the outcomes of DBE cases performed at the hospital during a two-year period. The physicians performed a total of 13 DBE procedures on 11 pediatric and adolescent patients. Prior to the DBE, all patients underwent a detailed diagnostic evaluation including laboratory testing and diagnostic radiologic imaging along with upper endoscopy, colonoscopy and capsule endoscopy (CE) tests. Abnormal small intestinal CE findings or continued small bowel disease symptoms without diagnosis by conventional methods were used as indications for DBE. Two of the patients underwent DBE for treatment of small intestinal polyps associated with Peutz-Jeghers Syndrome which dramatically improved their symptoms of abdominal pain and bleeding. Another patient's DBE was done to remove a bleeding small intestinal vascular malformation that had caused years of symptoms resolving chronic anemia. Two other patients had histories of bloody diarrhea, anorexia and weight loss; lower DBE provided evidence leading to the diagnosis of Crohn's disease when other medical techniques had been unsuccessful. see this http://www.news-medical.net/news/20100927/Double-Balloon-Enteroscopy-shows-potential-benefits-in-children.aspx












Study: Double Balloon Enteroscopy Safe and Effective



Balloon assisted or deep enteroscopy is a procedure which can allow the advancement of a long endoscope (called an enteroscope) into the small intestine for both diagnostic and therapeutic purposes. Balloon assisted enteroscopy may use a one or two balloon system. The system using two balloons is called double balloon enteroscopy (DBE). The balloon assisted enteroscopy technique advances the endoscope through the small bowel by alternately inflating and deflating balloons, and pleating the small bowel over an insertion tube like a curtain over a rod. The procedure can be performed via the upper gastrointestinal (GI) tract (antegrade) or through the lower GI tract (retrograde).The procedure is indicated for patients who have problems in the small intestine including bleeding, strictures, abnormal tissue, polyps, or tumors. Since the first article introducing DBE was published in GIE: Gastrointestinal Endoscopy in 2001, DBE has been widely used in clinical practice worldwide. {vpipagebreak} Methods Up until now, there have been many published original articles across the world addressing the technical aspects and positive findings of DBE. However, most of these studies were of small sample size and show inconsistent, if not controversial, data among different settings and in different countries. Therefore, the researchers performed this systematic review of all eligible studies related to diagnostic DBE during the decade of development in order to produce state-of-the-art data on indications, lesion detection rate, total enteroscopy, and complications in examining diseases of the small intestine. The researchers, led by Zhuan Liao, MD, and Zhao-Shen Li, MD, Department of Internal Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China, searched PubMed between January 1, 2001 and March 31, 2010 for original articles about DBE evaluation of diseases of the small intestine. Data on total number of procedures, distribution of indications, pooled detection rate, pooled total enteroscopy rate, and composition of positive findings were extracted and/or calculated. In addition, the data involving DBE-associated complications were analyzed. Indications were defined as the primary reasons for DBE. DBE findings that could explain the symptoms of the patient and resulted in a change in therapeutic management were considered positive findings, and these included any clinically significant findings in the entire GI tract. Total enteroscopy was defined when the entire small intestine was successfully visualized. Complications of DBE were defined as any adverse events that occurred during and after the procedures and were divided into minor and major categories. Minor complications included GI symptoms such as nausea, vomiting, abdominal distension, and other transient and self-limiting symptoms. best site http://www.endonurse.com/news/2011/09/study-double-balloon-enteroscopy-safe-and-effective.aspx