INDICATIONS AND DIAGNOSTIC YIELD OF SINGLE-BALLOON ASSISTED ENTEROSCOPY: AN EXPERIENCE IN A TERTIARY CARE CENTER OF A LOW INCOME COUNTRY

ABSTRACT

AIM: Enteroscopy is an endoscopic procedure to approach the small intestine in order to diagnose and treat various pathologies. The aim of this study is to share the experience of our center with this modality and highlight the main indications and diagnostic yield pf the procedure. METHODS: This is a single center retrospective study at Aga Khan University Hospital Karachi, Pakistan in which we included all the enteroscopies done in last five years. RESULTS: A total of 37 enteroscopies were done in past five years, the numbers has reduced significantly in the Covid-19 era. The mean age was 50.4 ± 16.5 years with 19 (51.4%) females and 18 (48.6%) males. The most common indications were jejunal thickening on CT scan 17 (45.9%) followed by obscure gastrointestinal bleeding 7 (18.9%) and chronic diarrhea 5 (13.5%). Most of the enteroscopies showed no gross pathology 17 (45.9%). However, jejunal ulcers 6 (16.2%), arteriovenous malformations 4 (10.8%), jejunal polyps 3 (8.1%), erythematous mucosa 2 (5.4%), pale mucosa 2 (5.4%), jejunal mass 2 (5.4%) and gastric polyp 1 (2.7%) are the findings noticed in rest of the enteroscopies performed. In 18 (48.6%) no biopsies were taken due to normal findings. 12 (32.4%) had nonspecific chronic inflammation in the jejunum. The remaining seven patient's histopathology showed giardiasis, MALTOMA, high grade B cell lymphoma, moderately differentiated adenocarcinoma, inflammatory polyp, hamartomatous polyp and adenomatous polyp. CONCLUSIONS: We shared the five year experience of enteroscopies done in our center which belongs to a low income country. The number of enteroscopies has greatly affected by the cost, low socioeconomic status of patients. Covid-19 has further reduced the number of diagnostic procedures in general. Most of the enteroscopies didn't reveal significant findings however there are cases where lymphoma and adenocarcinoma has been diagnosed.