Diagnostic and Therapeutic Utility of Double‐Balloon Enteroscopy in Children

Urs, Arun; Martinelli, Massimo; Rao, P. V. V. Prasada; Thomson, Mike

doi:10.1097/mpg.0000000000000192

Cited by 42 publications

(71 citation statements)

References 46 publications

(118 reference statements)

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“…Balloonassisted enteroscopy can be performed via the oral and rectal approach. It has been mainly studied in adults between the ages of 18 and 70 years but appears to be safe in the elderly population (over 70 years in age), as well as in children ( 79,80 ). Yamamoto et al ( 81 ).…”

Section: Deep Enteroscopymentioning

confidence: 98%

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Gerson

Fidler

Cave³

et al. 2015

American Journal of Gastroenterology

563

559

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Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended for patients with initial negative small bowel evaluations and ongoing overt or occult bleeding.

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Section: Deep Enteroscopymentioning

confidence: 98%

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Gerson

Fidler

Cave³

et al. 2015

American Journal of Gastroenterology

563

559

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“…Recent paediatric reports have shown diagnostic yields of between 50% and 81% and therapeutic yields of between 40% and 64%. 7,8,28,29 Small bowel polyps, ulcer, angiodysplasias, Crohn's disease and Meckel's diverticulum are the prevalent causes of bleeding ( Figure 1). Therapeutic interventions such as polypectomy, argon plasma coagulation and clip placement have been described.…”

Section: Obscure Gastrointestinal Bleeding (Ogib)mentioning

confidence: 99%

“…In adults, the role of BAE in the management of patients with Crohn's disease (CD) has been described in the endoscopy guidelines of the ECCO. 24,38 Four studies, two of SBE and two of DBE, 18,29,39,40 evaluated the impact of BAE in children with suspected and established CD. In our study, 16 paediatric patients with suspected CD and nonspecific findings at upper and lower gastrointestinal endoscopy were evaluated by SBE.…”

Section: Crohn's Diseasementioning

confidence: 99%

Enteroscopy in children

Nardo

Calabrese

Nibali³

et al. 2018

UEG Journal

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“…2 It has a high diagnostic rate for small bowel disease and can be performed safely even in young children. 3 Therefore, TADBE could be considered the most feasible diagnostic tool for bleeding MD. The technical difficulties involved in performing TADBE in a child <12 kg bodyweight (as in the present case) plus the limited availability of DBE in emergency situations could be considered limitations of this technique.…”

Section: Diagnosis Of Meckel Diverticulum On Endoscopic Retrograde Ilmentioning

confidence: 99%

“…Recently, transanal DBE (TADBE) has proved useful for accurate preoperative diagnosis of MD . It has a high diagnostic rate for small bowel disease and can be performed safely even in young children . Therefore, TADBE could be considered the most feasible diagnostic tool for bleeding MD.…”

mentioning

confidence: 99%