Small bowel obstruction due to a bezoar diagnosed by double-balloon enteroscopy / 대한내과학회지

To examine diseases of the small intestines, the use of different methods including a small bowel series and push type enteroscopy have been employed, but these procedures are restrictive and have a low diagnostic accuracy rate. Recently, the use of double balloon enteroscopy has been introduced, and it is expected that this procedure will be of great value for research of diseases of the small intestine as it enables one to obtain a biopsy tissue sample and to perform diagnostic and therapeutic endoscopy while examining small intestine visually. We report as case of a patient that visited our institution complaining of abdominal pain, and the patient was diagnosed as suffereing from an intestinal obstruction due to a bezoar. The patient was treated by surgery after an investigation with the aid of a double balloon enteroscope.

A Case of Pancreatic Arteriovenous Malformation Presenting Upper Gastrointestinal Bleeding / 대한소화기내시경학회지

A pancreatic arteriovenous malformation (AVM) is a very rare disease entity that is usually asymptomatic; however, it may present with a massive gastrointestinal hemorrhage. Recent advances in cross-sectional imaging and the widespread availability of angiography have contributed to the diagnosis of this condition. A patient was transferred to our clinic due to unknown origin gastrointestinal bleeding and upper abdominal pain. Double balloon enteroscopy and duodenoscopy revealed a bleeding pancreatico-cholangio-duodenal fistula. We were able to diagnose an arteriovnous malformation with a pancreatico-cholangio-duodenal fistula by the use of angiography and from the post-operative pathological findings.

Comparison of Double Balloon Enteroscopy and Capsule Endoscopy for Patients with Suspected Small Bowel Diseases / 대한소화기내시경학회지

BACKGROUND/AIMS: Double balloon enteroscopy (DBE) and capsule endoscopy (CE) are two new methods for evaluating small bowel diseases. However, the clinical relevance of these procedures remains to be uncovered. We investigated the diagnostic and therapeutic impact of DBE and CE for patients with suspected small bowel diseases. METHODS: We retrospectively reviewed the medical records of 60 patients who were examined by DBE or CE for suspected small bowel diseases between May 2003 and September 2005. The diagnostic yield and therapeutic impact were compared between the two groups. RESULTS: Thirty-five patients were examined by CE and 25 patients were examined by DBE. DBE showed abnormal findings in 20 patients (80%). CE detected abnormal findings in 23 patients (65.7%). The overall diagnostic yield was not different between the two groups (p=0.226). In the DBE group, therapeutic interventions were performed in 18 patients (72%). In the CE group, therapeutic interventions were performed in 7 patients (20%). The overall therapeutic impact showed a significant difference between the two procedures (p<0.001). CONCLUSIONS: Although there is no significant difference in the diagnostic yield between the two procedures, DBE appears to have a higher therapeutic yield than CE for patients with suspected small bowel diseases.

A Case of Proximal Jejunal Diverticular Bleeding Diagnosed by Double Balloon Enteroscopy and Treated by Colonoscopic Hemoclipping / 대한소화기내시경학회지

Although the development of wireless capsule endoscopy made it possible to visualize the entire small bowel endoscopically, capsule endoscopy has some limitations such as the impossibility of taking biopsies and carrying out therapeutic interventions. The new double-balloon method of enteroscopy has advantages over capsule endoscopy or push enteroscopy. This method is possible to take biopsies and perform therapeutic procedures such as thermal coagulation, injection, or polypectomy. It is also possible to visualize entire small bowel through oral and anal approach and improve endoscopic image by rinsing and air insufflation. We herein report a case of proximal jejunal diverticular bleeding diagnosed by double-balloon enteroscopy.