Diagnostic and therapeutic value of 1.4-metre colonoscope for upper jejunum lesions / 中华消化内镜杂志

ABSTRACT

Objective To study the diagnostic and therapeutic value of 1.4-metre colonoscope for upper jejunum lesions. Methods From 2008 to 2009, patients with suspected upper jejunum lesions, who presented as obscure gastrointestinal bleeding or other digestive symptoms and got no definite diagnosis from gastroscopy and entire digestive tract barium meal, were recruited as experimental group (n = 115) and underwent an examination with 1.4-metre endoscope. The endoscope was inserted into proximal jejunum, biopsy or treatment was performed according to the found lesions. Another 115 patients from 2004 to 2007, who presented with similar situation but were examined with gastroscope, were recruited as control group. Results Descending duodenum was accessed successfully in all cases from 2 groups. Horizontal duodenum was accessed in 112 and 107 cases of experimental group and control, respectively (97. 39% vs. 93.04%, P ＞0. 05), while the ascending part was accessed in 109 and 72 cases, respectively (94.78% vs. 62.61%, P＜0.005), and the proximal jejunum was accessed in 102 and 35 cases, respectively (88.70% vs. 30. 43%, P ＜ 0. 005). A total of 31 (26. 96%) lesions were found in experimental group, which was significantly higher than that in control group (6/115, 5.22%, P ＜0.005). Biopsy or endoscopic management was performed in 20 cases from experimental group, in which 12 occupying lesions were confirmed by pathology and surgery. In control group, 1 case of stromal tumor, 1 adenocarcinma, 1 P-J syndrome and 3 ancylostomiasis at horizontal duodenum were confirmed. Conclusion 1.4-metre endoscope can be inserted deeper than gastroscope, and is of better diagnostic value for bleeding in descending duodenum, especially in upper jejunum.