The use of single balloon enteroscopy in Crohn’s disease and its impact on clinical outcome

Abstract

SBE has a high diagnostic and therapeutic yield in CD and significantly impacts disease management. Careful patient selection is a key factor in optimizing its use in CD.

Enteroscopy in children and adults with inflammatory bowel disease

“…According to the studies considered in this review, as shown in Table 2 , the diagnostic yields of DAE in adult patients with suspected CD and with known CD is 27%-79% and 53%-87%, respectively, and are higher if the indication for DAE is based on previous SB investigations that may identify suspected lesions and guide the choice of insertion route[ 25 , 26 , 28 ]. Meanwhile, the diagnostic yield of DAE drops drastically when the indication is placed exclusively based on non-specific abdominal symptoms[ 34 ].…”

“…The diagnostic yield was 39%, detecting four patients with active ileitis and one with ileal stricture. For the remaining eight patients, a new diagnosis of CD was reached in 4 patients (8%) and excluded in the other 4 patients (8%)[ 28 ].…”

“…Holleran et al [ 28 ] evaluated the diagnostic yield and the impact on clinical outcome of the use of SBE for 39 patients with established SB-CD. In this setting, the diagnostic yield was significantly higher than for adult patients with suspected CD (77% vs 39%, P < 0.01).…”

“…Regarding the therapeutic role of enteroscopy in adult patients with IBD complications, several studies evaluated the clinical impact of EBD using BAE for SB stricture in CD (Table 4 )[ 25 , 28 , 33 , 37 - 45 ]. Among them, Hirai et al [ 45 ] conducted, to our knowledge, the largest multicenter study currently available, which prospectively enrolled 112 patients with symptomatic SB strictures related to CD to clarify the efficacy and safety of EBD.…”

“…Univariate logistic regression analysis showed that patients with IBD, irrespective of steroid therapy, had a significantly higher risk of perforation than patients without (8.6-fold and 2.5-fold, respectively)[ 47 ]. In most published studies, the perforation rate among CD patients who underwent EBD varied from 0% to 10% of subjects[ 25 , 28 , 33 , 37 - 41 , 44 , 45 ], although one small cohort reported a perforation rate of 20%[ 42 ] (Table 4 ). Bleeding after balloon dilation of CD strictures occurs in approximately 2.5% of patients, and it only often requires conservative management[ 25 ].…”