Comparative study of double-balloon enteroscopy and capsule endoscopy in etiological diagnosis of small intestine bleeding / 中华消化杂志

ABSTRACT

Objective To evaluate the diagnostic yield and accuracy of double balloon enteroscopy and capsule endoscopy in patients with obscure small bowel hemorrhage. Methods Twenty four patients with obscure small bowel hemorrhage were performed double balloon enteroscopy and wireless capsule endoscopy separately. The route of enteroscopy could be underwent either via mouth or via anus. Negative result of initial route was required afterwards for another via mouth or via anus examination. Capsule endoscope produced by GIVEN Imaging Company was used. The results of both methods were analyzed independently and final diagnosis of each case was compared thereafter. Results Totally 21 of 24 (87.5%) patients had positive findings with enterosocpy, while 11 of 24 (45.8%) patients had positive findings with capsule endoscopy. The etiological diagnosis of enteroscopy in all cases was confirmed by surgical exploration and pathological examination with the accuracy of 87.5% , however, the accuracy of capsule endoscopy was only 25% (6 cases). On assessment of procedure tolerance, double balloon enteroscopy under anaesthesia and capsule endoscopy were well tolerated than via mouth or anus route enteroscopy without anaesthesia. There was no severe procedure related complications. Conclusions The entire small intestine could be examined by double balloon enteroscopy with combination of mouth and anus route. Double balloon enteroscopy was superior to capsule endoscopy in etiological diagnosis of obscure small bowel bleeding. Capsule endoscopy had clinical diagnostic value in detection of multiple and long segment small bowel lesions. Double balloon enteroscopy could be served as the first option in diagnosis of obscure small bowel bleeding.