Double-Balloon Enteroscopy: Preliminary Experience in Patients with Obscure Gastrointestinal Bleeding or Chronic Abdominal Pain

May, Andrea; Nachbar, Lars; Wardak, Ahad; Yamamoto, Hironori; Ell, Christian

doi:10.1055/s-2003-44582

Cited by 206 publications

(105 citation statements)

References 13 publications

(17 reference statements)

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“…May et al [24] recently described a new method of carrying out enteroscopy using a double-balloon technique which allows not only diagnostic but also therapeutic endoscopic interventions for lesions in the small bowel. There is very limited and preliminary experience with this new tool and only non-comparative data are currently available, but it might become a complementary tool to CE diagnostic studies in the future.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Fireman

Friedman²

2004

Digestion

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Objectives:Chronic occult blood loss from the gastrointestinal tract is a recognized major cause of iron-deficiency anemia. After conventional investigation of the upper and lower parts of the gastrointestinal tract, the source of bleeding remains unidentified in ~10% of these patients. We evaluated the diagnostic yield of capsule endoscopy from patients enrolled in clinical studies due to persistent or recurrent iron-deficiency anemia. Methods: In this large cohort study, patients with obscure gastrointestinal bleeding were identified in a company-sponsored clinical study (Given Imaging, Ltd.) database which contains data from >50 clinical studies. Information on suitable patients was derived from 31 of them. Each subject swallowed an M2A^® Given Capsule containing a miniature video camera, batteries, a transmitter and an antenna. Recording time was ~8 h. The capsule was excreted naturally in the patient’s bowel movement, and the data it transmitted were retrieved and interpreted the next day. Results: 293 patients were studied (135 males, 46.1%, mean age 59.4 ± 16.8 years) whose mean number of bleeding episodes was 4.3 ± 5.5 and mean hemoglobin level was 9.8 ± 2.4 g/dl. The average number of diagnostic procedures per patient prior to the capsule endoscopy study was 5.59. Capsule endoscopy detected definitive findings in 213/293 patients (72%) and findings missed by other diagnostic procedures in 22/293 patients (8%). Neither capsule endoscopy nor the other diagnostic procedures yielded diagnoses in 58/293 patients (20%). Conclusions: Capsule endoscopy has a high diagnostic yield in evaluating patients with obscure gastrointestinal bleeding.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Fireman

Friedman²

2004

Digestion

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“…The volume was not documented, it was therefore not possible to examine if the individual amount of fluid intake had any effect on CE quality. Double balloon enteroscopy (DBE) is another recent tool for examination of the small bowel [24][25][26] . Requirement for more manpower and a slightly increased complication rate are some disadvantages of DBE compared to CE [27,28] .…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of small bowel preparation with bisacodyl and sodium phosphate for capsule endoscopy

Franke¹,

Hummel²,

Knebel³

et al. 2008

WJG

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AIM: To determine the effect of Prepacol® , a combination of sodium phosphate and bisacodyl, on transit and quality of capsule endoscopy (CE). METHODS:Fivety two consecutive patients were included in this prospective study. CE was performed following a 12 h fasting period. Twenty six patients were randomized for additional preparation with Prepacol ® . The quality of CE was assessed separately for the proximal and the distal small bowel by 3 experienced endoscopists on the basis of a graduation which was initially developed with 20 previous CE. RESULTS: Preparation with Prepacol® accelerated small bowel transit time (262 ± 55 min vs 287 ± 97 min), but had no effect on the quality of CE. Visibility was significantly reduced in the distal compared to the proximal small bowel. CONCLUSION:The significantly reduced visibility of CE in the distal small bowel allocates the need for a good preparation. Since Prepacol ® has no beneficial effect on CE the modality of preparation and the ideal time of application remains unclear. Further standardized examinations are necessary to identify sufficient preparation procedures and to determine the impact of the volume of the preparation solution.

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“…Primary small bowel bezoars are very rare and may cause acute abdomen due to SBO (1, (13,14). DBE is a safe, feasible diagnostic tool that allows high-resolution endoscopic imaging and total enteroscopy, and provides the capability of obtaining tissue for histological studies (3,15). DBE also appears to be a safe and useful diagnostic tool in patients with SBO, and the findings of DBE influence the strategy of therapy in patients in whom the cause of SBO could not be determined by conventional radiography (16) (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%