This is the first Latin American Consensus of the Pan American Crohn's and Colitis Organisation (PANCCO) regarding special situations in patients with inflammatory bowel disease (IBD). The aim of this consensus is to raise awareness in the medical community in all Latin American countries with respect to pregnancy, vaccinations, infections, neoplasms, including colorectal cancer, and pediatric issues in patients with IBD.
Balloon-assisted enteroscopy has proved to be effective in the diagnosis and treatment of small bowel lesions previously visualized by other methods. Few studies evaluate the usefulness of endoscopic capsule (EC) and non-invasive imaging studies preceding simple balloon enteroscopy (SBE). This work represents a contribution to a better understanding of the SBE in relation to the diagnostic yield as a second study and the existing coincidence between enteroscopy and the different preceding studies regarding lesions location. Material and methods. An analytical and observational study of a retrospective cohort of patients referred for SBE. Consecutive patients, who underwent SBE at the Hospital Italiano de Buenos Aires, were included between September 2010 and June 2017. Results. 140 SBE performed in 120 patients were analyzed. The access route was ante-grade in 91% of the studies. The most frequent indication was obscure gastrointestinal bleeding (41%). 50% of the patients had carried out an EC before the study, 27% had an enterotomography (ETC) or enteroresonance (ERMN) and 21% presented both studies. The overall diagnosis of lesions was 70%. The most frequent finding was angiodysplasias (46%) and was higher when the enteroscopy was preceded by CE compared with ETC or ERMN (76% vs. 61%; p = 0.06). The agreement between CE and ESB was moderate for the lesions diagnosis (Kappa 0.4194; p < 0.001) and good its localization (Kappa 0.6337; p < 0.001). Conclusions. SBE in our center is a procedure with a high diagnostic yield. This yield gets higher and the topographic agreement of the lesions is greater when it is carried out in a directed way after an EC.
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