ABSTRACT
A 68-years-old man was admitted to hospital with signs of intestinal obstruction. Computed tomography showed a foreign body, and the patient underwent laparotomy which revealed a gold filling in the jejunum. To our knowledge, this is the first documented case of a gold filling causing intestinal obstruction.
Subject(s)
Foreign Bodies , Gold Alloys , Ileus/etiology , Jejunal Diseases/etiology , Aged , Bezoars/diagnostic imaging , Diagnosis, Differential , Foreign Bodies/diagnostic imaging , Humans , Ileus/diagnostic imaging , Ileus/surgery , Jejunal Diseases/diagnostic imaging , Jejunal Diseases/surgery , Male , Tomography, X-Ray ComputedABSTRACT
INTRODUCTION: Double-balloon endoscopy (DBE) is a novel technique for diagnosis and treatment of small bowel diseases. This study describes the first Danish experiences with DBE. MATERIALS AND METHODS: Retrospective study of 31 consecutive patients examined with DBE at Gentofte Hospital from March 2004 to September 2006. RESULTS: A total of 42 DBE (32 oral, ten anal) were performed. Insertion-length for the oral and anal DBE was 206 cm (range 40-500 cm) beyond the Ligament of Treitz and 141 cm (range 10-200 cm) beyond the ileo-cecal valve, respectively. Duration was 128 min/124 min (range 55-285 min/60-155 min), respectively. In two patients a total inspection of the small bowel was possible. The diagnostic yield was 74% (CI: 57%-86%) with a therapeutic yield in 21 patients (68% CI: 50%-81%). One major complication with perforation occurred due to improper handling of the endoscope. CONCLUSION: DBE is a new effective method for the diagnosis and treatment of small bowel diseases. If used correctly, DBE is safe with few complications. DBE is expected to become an essential endoscopic method for handling small bowel diseases in close conjunction with capsule endoscopy. DBE demands considerable resources and requires experience with advanced endoscopic techniques and hence should be limited to only a few national centres.
Subject(s)
Endoscopy, Gastrointestinal , Intestinal Diseases/diagnosis , Intestine, Small , Adolescent , Adult , Aged , Aged, 80 and over , Capsule Endoscopy , Crohn Disease/diagnosis , Crohn Disease/pathology , Endoscopes, Gastrointestinal/adverse effects , Endoscopy, Gastrointestinal/adverse effects , Endoscopy, Gastrointestinal/methods , Female , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/pathology , Humans , Intestinal Diseases/pathology , Intestinal Neoplasms/diagnosis , Intestinal Neoplasms/pathology , Intestine, Small/pathology , Male , Middle Aged , Retrospective StudiesABSTRACT
Double balloon endoscopy (DBE) is a new method that enables endoscopy of the entire small intestine. The indications are primarily diagnosis and therapy of obscure gastrointestinal bleeding, Crohn's disease, tumours and polyps. The endoscope and procedure is described and an overview of the indications and experience with DBE is given based on a literature review. The method is a significant advance in gastrointestinal endoscopy.
