Analysis of Double Balloon Enteroscopy: Indications, Findings, Therapeutic and Complications

Abstract

Background: The double balloon enteroscopy is an important method for the endoscopic approach of the small bowel that provides diagnosis and therapy of this segment’s disorders, with low complication rate. Aim: Analysis of patients undergoing double balloon enteroscopy. The specific objectives were to establish the indications for this method, evaluate the findings by the double balloon enteroscopy, analyze the therapeutic options and the complications of the procedure. Methods: It is a retrospective analysis of 65 patients who underwent double balloon enteroscopy. Results: Sixty-five procedures were performed in 50 patients, 63.1% were women and 36.9% were men. The mean age was 50.94 years. The main indication it was gastrointestinal bleeding, followed by abdominal pain and Crohn’s disease. Most procedures were considered normal. Polyps were the most prevalent finding, followed by angioectasias and duodenitis. In 49.2% of the cases, one or more therapeutic procedures were performed, (biopsy was the most prevalent). There was only one case of acute pancreatitis, which was treated clinically. Conclusion: The enteroscopy is good and safe method for the evaluation of the small bowel, and its main indications are gastrointestinal bleeding and abdominal pain. It has low complications rates and reduces the necessity of surgery.

Enteroscopia de doble balón: experiencia inicial en un hospital universitario

“…A nivel local se han publicado, hasta la fecha, una serie de casos de pacientes llevados a enteroscopia de un solo balón (1) y otra de EDB (19) ; asimismo, recientemente se publicó la experiencia específica en hemorragia (20) . La mediana de edad en este estudio fue similar a las series reportadas de EDB (5,(21)(22)(23)(24) .…”

“…La hemorragia digestiva potencial del intestino delgado fue también la indicación más frecuente de EDB en otras series de casos, incluidos los publicados en Latinoamérica (3,5,19,21,22,24,25) y en una revisión que incluyó 66 estudios con 12 823 procedimientos publicados entre 2001 y 2010 (26) . Lo anterior permite definir que es un método para el diagnóstico y tratamiento de esta entidad.…”

“…La vía anterógrada fue la más frecuente, y esta es la más empleada también en las series de casos reportadas (5,21,23,24) . Lo anterior obedece a que, si se desconoce la ubicación de una lesión, generalmente se utiliza la vía anterógrada porque la técnica retrógrada es más compleja, requiere de preparación, se logra explorar menos intestino y en ocasiones no se logra canalizar la válvula ileocecal (22) .…”

Endoscopic Retrograde Cholangiopancreatography (Ercp): Analysis of the Effectiveness and Safety of the Procedure in the Patient With Roux-en-Y Gastric Bypass

“…Cannulation of the duodenal papilla is obtained in almost all cases (89-100%) 3 , 6 , 7 , 8 , 14 , 17 , 21 , which was also found in the present study, with 100% success of the technique. In addition, the gastrostomy route is superior to the technique of double balloon enteroscopy 7 , 12 , since it has no lateral vision, making it difficult to canalize the papilla and doing therapeutic procedures. In addition, specific equipment is required for the enteroscope, a longer operative time - which is reasonable for treating gallstone disease of the bile ducts -, but unsuitable for pancreatic diseases or dysfunction of the sphincter of Oddi.…”

Carvedilol as Primary Prophylaxis for Gastric Variceal Bleeding in Portal Hypertension Model in Rats

“…In the last 30 years, mortality due to variceal bleeding has decreased significantly. This occurred due to numerous factors, but mainly as consequence of the improvement in the therapeutic options 5 , 6 . The use of non-selective beta-blockers, particularly propranolol, and endoscopic varicose vein ligation are the first-line treatment to prevent bleeding 2 .…”