Clinical Endoscopy

Original Article

Endoscopic and histological characteristics of small bowel tumors diagnosed by double-balloon enteroscopy: Suleyman Dolu, Soner Onem, Zarni Htway, Farid Hajıyev, Ali Bilgen, Hatice Cilem Binicier, Ecem Kalemoglu, Ozgul Sagol, Mesut Akarsu; Clin Endosc 2023;56(1):83-91. Published online October 27, 2022; DOI: https://doi.org/10.5946/ce.2022.131

Abstract PDF PubReader ePub: Background
/Aims: Double-balloon enteroscopy (DBE) allows for the diagnoses and treatment of small bowel tumors (SBTs). This study aimed to evaluate the utility of DBE for the diagnosis and treatment of SBTs.
Methods
Patients diagnosed with SBTs who underwent DBE were included in this study. According to their endoscopic appearances, they were categorized as polyps or masses, and according to their histological characteristics, they were categorized as benign or malignant SBTs.
Results
A total of 704 patients were retrospectively analyzed, and 90 (12.8%) were diagnosed with SBTs. According to their endoscopic appearance, 48 (53.3%) had polyps and 42 (46.7%) had masses. Additionally, 53 (58.9%) and 37 (41.1%) patients had malignant and benign SBTs, respectively, depending on their histological characteristics. Patients diagnosed with polyps were younger than those diagnosed with masses (p<0.001). Patients diagnosed with benign SBTs were younger than those diagnosed with malignant SBT (p<0.001). Overall, histological diagnosis was determined using DBE in 73 (81.1%) patients.
Conclusions
DBE is a useful method for diagnosing SBTs. Additionally, the histological type of the lesion can be determined using DBE.

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Case Report

Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report: Christophe Riquoir, Luis Antonio Díaz, David Chiliquinga, Roberto Candia, Fernando Pimentel, Alex Arenas; Clin Endosc 2021;54(5):754-758. Published online May 25, 2021; DOI: https://doi.org/10.5946/ce.2021.060

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The Roux-en-Y gastric bypass is one of the most extensive surgical treatments for obesity. The treatment of upper gastrointestinal bleeding after Roux-en-Y gastric bypass is complex due to the difficulty of accessing the excluded gastric antrum and duodenal bulb. There is no consensus regarding the management of this complication. While various techniques have been described to access the biliopancreatic limb, double-balloon enteroscopy is the most commonly used. If double-balloon enteroscopy is unavailable, a pediatric colonoscope may be used as an alternative; however, its use in such cases has not been described. We report the case of a 50-year-old male patient who underwent gastric bypass 13 years ago and was admitted for a second episode of upper gastrointestinal bleeding. The initial approach using upper endoscopy, colonoscopy, and abdominal computed tomography angiography did not reveal the cause of gastrointestinal hemorrhage; therefore, an endoscopic study of the biliopancreatic limb was performed using a pediatric colonoscope. A Forrest Ib ulcer was found in the duodenal bulb, and endoscopic therapy was administered. The evolution was found to be satisfactory.

Citations

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Endoscopic management of postoperative bleeding
Sung Hyeok Ryou, Ki Bae Bang
Clinical Endoscopy.2023; 56(6): 706. CrossRef

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Focused Review Series: Present and Future of Diagnosis and Management of Small Bowel Diseases Exploiting Artificial Intelligence and Advanced Endoscopy

Roles of Capsule Endoscopy and Balloon-Assisted Enteroscopy in the Optimal Management of Small Bowel Bleeding: Hani Abutalib, Tomonori Yano, Satoshi Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2020;53(4):402-409. Published online July 30, 2020; DOI: https://doi.org/10.5946/ce.2020.143

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The small bowel had long been considered a dark unapproachable tunnel until the invention of capsule endoscopy and doubleballoon enteroscopy in the 21st century, which revolutionized the diagnosis and management of small bowel diseases, including bleeding. Various imaging modalities such as computed tomographic enterography, angiography, capsule endoscopy, and balloonassisted enteroscopy play vital roles in the diagnosis and management of small bowel bleeding. The choice of modality to use and timing of application differ according to the availability of the modalities, patient’s history, and physician’s experience. Small bowel bleeding is managed using different strategies as exemplified by medical treatment, interventional radiology, endoscopic therapy, or surgical intervention. Balloon-assisted enteroscopy enables endoscopic interventions to control small bowel bleeding, including electrocautery, argon plasma coagulation, clip application, and tattooing as a prelude to surgery. In this article, we clarify the recent approaches to the optimal diagnosis and management of patients with small bowel bleeding.

Citations

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A practical approach for small bowel bleeding
Sung Eun Kim, Hyun Jin Kim, Myeongseok Koh, Min Cheol Kim, Joon Sung Kim, Ji Hyung Nam, Young Kwan Cho, A Reum Choe
Clinical Endoscopy.2023; 56(3): 283. CrossRef
Indication, Location of the Lesion, Diagnostic Yield, and Therapeutic Yield of Double-Balloon Enteroscopy: Seventeen Years of Experience
Sang Pyo Lee, Hyun Joo Jang, Sea Hyub Kae, Jae Gon Lee, Ji Hye Kwon
Diagnostics.2022; 12(9): 2224. CrossRef
Application of capsule endoscopy in patients with chronic and recurrent abdominal pain
Wei Yang, Zheng Li, Rui Liu, Xudong Tong, Wei Wang, Dongqiang Xu, Shan Gao
Medical Engineering & Physics.2022; 110: 103901. CrossRef

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Focused Review Series: Training in Endoscopy

Training in Endoscopy: Enteroscopy: Jinsu Kim; Clin Endosc 2017;50(4):328-333. Published online July 31, 2017; DOI: https://doi.org/10.5946/ce.2017.089

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The balloon-assisted enteroscope has been regarded as the standard device for direct visualization of deep small bowels and allows for the diagnosis and treatment of small bowel disease. At the beginning, its application was focused on the diagnosis of obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel tumor. However, the indications are being expanded to various therapeutic procedures, not only confined to bleeding control. With the expansion of the indications, the need to perform enteroscopy effectively and safely is increasing. Recent studies have been focused on the diagnostic yield, therapeutic yield, and long-term outcomes of the device. However, with the increasing number of procedures, procedural guidelines and quality indicators are also needed.

Citations

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Performance of pan‐enteroscopy in children with intestinal failure due to short bowel syndrome: A single‐center retrospective study
Jonathan A. Salazar, Christina Chan, Enju Liu, Fatima Hamroud, Amit S. Grover, Victor L. Fox, Peter D. Ngo, Lissette Jimenez, Christopher P. Duggan, Alexandra N. Carey
Journal of Pediatric Gastroenterology and Nutrition.2024;[Epub] CrossRef
The Role of Endoscopy in the Diagnosis and Management of Small Bowel Pathology in Children
Amornluck Krasaelap, Diana G. Lerner, Salvatore Oliva
Gastrointestinal Endoscopy Clinics of North America.2023; 33(2): 423. CrossRef
A systematic review of symptomatic hamartomas of the jejunum and ileum
N Farkas, M Conroy, M Baig
The Annals of The Royal College of Surgeons of England.2022; 104(1): 18. CrossRef
Clinicopathological Features of Small Bowel Tumors Diagnosed by Video Capsule Endoscopy and Balloon-Assisted Enteroscopy: A Single Center Experience
Ah Young Yoo, Beom Jae Lee, Won Shik Kim, Seong Min Kim, Seung Han Kim, Moon Kyung Joo, Hyo Jung Kim, Jong-Jae Park
Clinical Endoscopy.2021; 54(1): 85. CrossRef
Device-assisted enteroscopy training. A rapid review
Federico Soria Gálvez, Octavio López-Albors, Pilar Esteban Delgado, Enrique Pérez-Cuadrado Robles, Rafael Latorre Reviriego
Revista Española de Enfermedades Digestivas.2020;[Epub] CrossRef
Balloon-Assisted Enteroscopy for Retrieval of Small Intestinal Foreign Bodies: A KASID Multicenter Study
Jeongseok Kim, Beom Jae Lee, Nam Seok Ham, Eun Hye Oh, Kee Don Choi, Byong Duk Ye, Jeong-Sik Byeon, Chang Soo Eun, Jin Su Kim, Dong-Hoon Yang
Gastroenterology Research and Practice.2020; 2020: 1. CrossRef
Enteroscopy in children and adults with inflammatory bowel disease
Giovanni Di Nardo, Gianluca Esposito, Chiara Ziparo, Federica Micheli, Luigi Masoni, Maria Pia Villa, Pasquale Parisi, Maria Beatrice Manca, Flavia Baccini, Vito Domenico Corleto
World Journal of Gastroenterology.2020; 26(39): 5944. CrossRef
Enteroscopy in children
Giovanni Di Nardo, Carlo Calabrese, Roberto Conti Nibali, Arianna De Matteis, Emanuele Casciani, Luigi Martemucci, Giuseppe Pagliaro, Nico Pagano
United European Gastroenterology Journal.2018; 6(7): 961. CrossRef
Motorized Spiral Enteroscopy for Occult Bleeding
Laura Mans, Marianna Arvanitakis, Horst Neuhaus, Jacques Devière
Digestive Diseases.2018; 36(4): 325. CrossRef
Comprehensive review of outcomes of endoscopic treatment of gastrointestinal bleeding
Tae-Geun Gweon, Jinsu Kim
International Journal of Gastrointestinal Intervention.2018; 7(3): 123. CrossRef
Balloon-Assisted Enteroscopy and Capsule Endoscopy in Suspected Small Bowel Crohn’s Disease
Hsu-Heng Yen, Chen-Wang Chang, Jen-Wei Chou, Shu-Chen Wei
Clinical Endoscopy.2017; 50(5): 417. CrossRef

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Review

Diagnostic and Therapeutic Capability of Double-Balloon Enteroscopy in Clinical Practice: Umit Akyuz, Filiz Akyuz; Clin Endosc 2016;49(2):157-160. Published online March 7, 2016; DOI: https://doi.org/10.5946/ce.2015.036

Abstract PDF PubReader ePub

Advances in technology have facilitated the common use of small-bowel imaging. Intraoperative enteroscopy was the gold standard method for small-bowel imaging. However, noninvasive capsule endoscopy and invasive balloon enteroscopy are currently the main endoscopic procedures that are routinely used for small-bowel pathologies, and the indications for both techniques are similar. Although obstruction is a contraindication for capsule endoscopy, it is not considered to be problematic for double-balloon enteroscopy. The most important advantage of double-balloon enteroscopy is the applicability of therapeutic interventions during the procedure; however, double-balloon enteroscopy has certain advantages as well as disadvantages.

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Mahmoud Aryan, Tyler Colvin, Ali M Ahmed, Kondal Rao Kyanam Kabir Baig, Shajan Peter
World Journal of Gastrointestinal Endoscopy.2022; 14(7): 434. CrossRef
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Bai-Rong Li, Tao Sun, Jing Li, Meng Li, Shou-Bin Ning, Xiao-Wei Jin, Ming Zhu, Gao-Ping Mao
Digestive Diseases and Sciences.2020; 65(9): 2630. CrossRef
Enteroscopia de doble balón: indicaciones, abordajes, eficacia diagnóstica y terapéutica y seguridad. Experiencia temprana de un solo centro
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México.2018; 83(1): 31. CrossRef
Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México (English Edition).2018; 83(1): 31. CrossRef
Double-Balloon Endoscopy in Overt and Occult Small Bowel Bleeding: Results, Complications, and Correlation with Prior Videocapsule Endoscopy in a Tertiary Referral Center
Carlijn Hermans, Arnold Stronkhorst, Annemarie Tjhie-Wensing, Jan Kamphuis, Bas van Balkom, Rob Dahlmans, Lennard Gilissen
Clinical Endoscopy.2017; 50(1): 69. CrossRef
Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
Clinical Endoscopy.2017; 50(4): 345. CrossRef

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Case Report

Successful Removal of a Screw Nail in the Jejunum Using Double-Balloon Enteroscopy: Dong Ju Kim, Myoung Ki Sim, Sang Wook Lee, Tae Hee Lee; Clin Endosc 2015;48(5):444-446. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.444

Abstract PDF PubReader ePub

The vast majority of foreign bodies (FBs) that enter the stomach pass through the gastrointestinal tract spontaneously. When the FB enters the small bowel-beyond the reach of conventional endoscopy-daily radiographs are needed to ensure its safe passage. However, endoscopic intervention is an appropriate management strategy for a sharp-pointed FB, because sharp FBs have a higher risk of intestinal perforation. We describe here a case in which a 1.5-cm, sharp-pointed screw nail in the proximal jejunum was removed successfully by double-balloon enteroscopy from a 19-year-old-male with autism. This case adds to the growing body of evidence demonstrating the value of therapeutic double-balloon enteroscopy in the field of FB ingestion

Citations

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Balloon-Assisted Enteroscopy for Retrieval of Small Intestinal Foreign Bodies: A KASID Multicenter Study
Jeongseok Kim, Beom Jae Lee, Nam Seok Ham, Eun Hye Oh, Kee Don Choi, Byong Duk Ye, Jeong-Sik Byeon, Chang Soo Eun, Jin Su Kim, Dong-Hoon Yang
Gastroenterology Research and Practice.2020; 2020: 1. CrossRef
Foreign Body Penetration through Jejunal Loops Causing Renal Artery Thrombosis and Renal Infarct
Najib Nassani, Elie El-Charabaty, Patricia Nasr, Iskandar Barakat, Sherif Andrawes
ACG Case Reports Journal.2017; 4(1): e12. CrossRef

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Review

Should Capsule Endoscopy Be the First Test for Every Obscure Gastrointestinal Bleeding?: Chung Hyun Tae, Ki-Nam Shim; Clin Endosc 2014;47(5):409-414. Published online September 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.5.409

Abstract PDF PubReader ePub

Obscure gastrointestinal bleeding (OGIB) refers to gastrointestinal (GI) bleeding of unclear origin that persists or recurs after negative findings on esophagogastroduodenoscopy and colonoscopy. OGIB accounts for approximately 5% of all types of GI bleeding. More than 80% of OGIB cases originate in the small bowel. The ability to detect OGIB in the small bowel has significantly advanced and been revolutionized since the introduction of the capsule endoscopy and double-balloon enteroscopy techniques in 2000 and 2001, respectively. With these new methods for small-bowel evaluation, new guidelines have been proposed for the diagnosis and management of OGIB. However, some issues remain unsolved. The purpose of this article is to review the various modalities used for evaluating OGIB, including capsule endoscopy and double-balloon enteroscopy, and to help guide clinicians in their decisions on which modality will be the most effective.

Citations

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Early intervention with double balloon enteroscopy for higher yield for inpatient overt obscure gastrointestinal bleeding: A propensity matched analysis
Mahmoud Aryan, Krishna V R Venkata, Tyler Colvin, Lauren Daley, Parth Patel, T. Mark Beasley, Benjamin Nunley, Nicholas Baldwin, Ali M Ahmed, Kondal R Kyanam Kabir Baig, Klaus Mönkemüller, Shajan Peter
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Clinical features of obscure gastrointestinal bleeding undergoing capsule endoscopy: A retrospective cohort study
Yuga Komaki, Shuji Kanmura, Kazuki Yutsudo, Kosuke Kuwazuru, Fukiko Komaki, Akihito Tanaka, Hidehito Maeda, Shiho Arima, Shiroh Tanoue, Fumisato Sasaki, Shinichi Hashimoto, Masahisa Horiuchi, Akio Ido, Gopal Krishna Dhali
PLOS ONE.2022; 17(3): e0265903. CrossRef
Enteroscopia de doble balón: indicaciones, abordajes, eficacia diagnóstica y terapéutica y seguridad. Experiencia temprana de un solo centro
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México.2018; 83(1): 31. CrossRef
Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México (English Edition).2018; 83(1): 31. CrossRef
Double-Balloon Endoscopy in Overt and Occult Small Bowel Bleeding: Results, Complications, and Correlation with Prior Videocapsule Endoscopy in a Tertiary Referral Center
Carlijn Hermans, Arnold Stronkhorst, Annemarie Tjhie-Wensing, Jan Kamphuis, Bas van Balkom, Rob Dahlmans, Lennard Gilissen
Clinical Endoscopy.2017; 50(1): 69. CrossRef
What is the Role of Double-Balloon Endoscopy in Patients Presenting with Obscure Gastrointestinal Bleeding?
Jung Ho Kim, Kwang An Kwon
Clinical Endoscopy.2017; 50(1): 8. CrossRef
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José Francisco Juanmartiñena Fernández, Iñaki Fernández-Urién Sainz, Beatriz Zabalza Ollo, Ana Borda Martín, Juan José Vila Costas
Revista Española de Enfermedades Digestivas.2017;[Epub] CrossRef
Gastroduodenal lesions detected during small bowel capsule endoscopy: incidence, diagnostic and therapeutic impact
José Francisco Juanmartiñena Fernández, Ignacio Fernández-Urien Sainz, Beatriz Zabalza Ollo, Cristina Saldaña Dueñas, Marta Montañés Guimera, Alfonso Elosua González, Juan José Vila Costas
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Ahilan Arulanandan, Parambir S Dulai, Siddharth Singh, William J Sandborn, Denise Kalmaz
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Zhi-Hong Zhang, Chun-Hua Qiu, Yi Li
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Peter Sadeghi, Sandro Lanzon-Miller
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Case Report

Small Bowel Stent-in-Stent Placement for Malignant Small Bowel Obstruction Using a Balloon-Assisted Overtube Technique: Daniel Popa, Jayapal Ramesh, Shajan Peter, C. Mel Wilcox, Klaus Mönkemüller; Clin Endosc 2014;47(1):108-111. Published online January 24, 2014; DOI: https://doi.org/10.5946/ce.2014.47.1.108

Abstract PDF PubReader ePub

Self-expanding metal stents are a useful therapy to palliate malignant and benign luminal gastrointestinal obstruction. Self-expanding metal stents has been widely reported for colonic, esophageal, and gastric obstruction. However, endoscopic delivery and placement to the small bowel is more challenging and difficult. This case illustrates the usefulness and technical advantages of the balloon-overtube and enteroscopy technique for the palliative treatment of neoplastic stenosis affecting the small intestine.

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Special Issue Article of IDEN 2013

Deep Enteroscopy: Which Technique Will Survive?: Seong Ran Jeon, Jin-Oh Kim; Clin Endosc 2013;46(5):480-485. Published online September 30, 2013; DOI: https://doi.org/10.5946/ce.2013.46.5.480

Abstract PDF PubReader ePub

The advent of deep enteroscopy (DE) has dramatically changed diagnostic and therapeutic approaches to small bowel diseases. Unlike capsule endoscopy, which is unable to obtain biopsies or treat a disease, DE techniques have diagnostic and therapeutic capabilities. Double-balloon enteroscopy (DBE) was introduced in 2001, and single-balloon enteroscopy (SBE) and spiral enteroscopy (SE) were subsequently developed for small bowel investigation. In published reports comparing these different enteroscopy techniques, most comparative parameters (depth of insertion, complications, learning curve, diagnostic yield, and therapeutic yield) were comparable among DBE, SBE, and SE. However, the procedure duration appears to be shorter for SE than for DBE and SBE. The rate of complete enteroscopy is clearly superior for DBE, compared with SE and SBE. Because these results do not indicate an increase in diagnostic or therapeutic yield, the clinical impact of complete enteroscopy remains controversial. According to previous studies, the three DE methods seem to be equally effective and safe in the clinical setting. Although larger randomized controlled trials are needed to evaluate the procedural characteristics and clinical impact, the selection of an enteroscopic technique should be based on availability and the endoscopist's experience.

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Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery
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BMC Gastroenterology.2016;[Epub] CrossRef
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Rabia Ali, Daniel Wild, Frederick Shieh, David L. Diehl, Monika Fischer, Wataru Tamura, David T. Rubin, Vivek Kumbhari, Patrick Okolo, Andrew Storm, Zamir Halpern, Helmut Neumann, Harshit S. Khara, Mark B. Pochapin, Seth A. Gross
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Small bowel intervention and application of enteroscopy for altered small bowel anatomy—endoscopic advanced therapy using double balloon enteroscopy
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Case Reports

Aortoenteric Fistula Diagnosed by Double Balloon Enteroscopy: A Case Report: Hyung Geun Yoon, Bong Min Ko, Jae Woong Tae, Su Jin Hong, Jong Ho Moon, Jin Oh Kim, Joon Seong Lee, Moon Sung Lee; Clin Endosc 2013;46(1):106-109. Published online January 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.1.106

Abstract PDF PubReader ePub

A secondary aortoenteric fistula (AEF) is a direct communication between the gastrointestinal tract and the aorta in a patient who has undergone major surgery on the aorta, often an aorta graft operation. We experienced a patient who had undergone graft interposition for abdominal aortic aneurysm and was admitted due to three episodes of hematemesis and following hamatochezia. Gastroscopy, colonoscopy, and radioactive iodine scan failed to identify the bleeding site in the patient. He was diagnosed with AEF by double balloon enteroscopy and recovered after surgical intervention.

Citations

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Aortic Bulge: A Possible Predictive Sign of Impending Aortoenteric Fistula
Patrick Kennedy, Sandra Monteiro, Gordon Yip, Fernando Gastaldo
Canadian Association of Radiologists Journal.2019; 70(2): 204. CrossRef
Editor's Choice – Management of Secondary Aorto-enteric and Other Abdominal Arterio-enteric Fistulas: A Review and Pooled Data Analysis
S.K. Kakkos, C.D. Bicknell, I.A. Tsolakis, D. Bergqvist
European Journal of Vascular and Endovascular Surgery.2016; 52(6): 770. CrossRef

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A Case of Giant Inflammatory Ileal Polyp Removed by Double-Balloon Enteroscopy: Dae Woong Yoon, Beom Jae Lee, Jae Hyoung Lee, Jong-Jae Park, Jae Seon Kim, Young-Tae Bak, Won Jae Choi, Young Jae Mok; Clin Endosc 2012;45(3):198-201. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.198

Abstract PDF PubReader ePub

Inflammatory fibroid polyps are rare benign tumors of the GI tract, that commonly present with intestinal obstruction as a result of intussusceptions in the small bowel. A 39-year old man visited our clinic with an asymptomatic polypoid mass in the distal ileum that was identified on abdominal computed tomography for postoperative surveillance after total gastrectomy due to previously diagnosed early gastric cancer. Retrograde double-balloon enteroscopy was performed to diagnose the ileal mass and a complete resection of the polyp was performed using snare for polypectomy without complications. The final histological finding was an ileal inflammatory polyp. Balloon-assisted enteroscopy is a valuable modality to diagnose and treat small bowel lesions in lieu of surgical procedures in selected cases.

Citations

Citations to this article as recorded by

Gel immersion endoscopic mucosal resection of small-bowel inflammatory fibroid polyp using double-balloon endoscopy
Yuka Matsubara, Akiyoshi Tsuboi, Issei Hirata, Akihiko Sumioka, Hidenori Tanaka, Ken Yamashita, Yuji Urabe, Shiro Oka
VideoGIE.2023;[Epub] CrossRef
Inflammatory Fibroid Polyp of Ileum with Intussusception
Eun Sun Lee
Korean Journal of Abdominal Radiology.2022; 6(1): 72. CrossRef
Masquerading in the midgut: a rare diagnosis in a patient with recurrent abdominal pain
Philip J Smith, Trusha Patel, Nicholas Reading, Konstantinos Giaslakiotis, Sami Hoque
Frontline Gastroenterology.2020; 11(5): 420. CrossRef
Pólipo fibroso inflamatorio (de Vaneck) como origen de hemorragia digestiva de origen oscuro
Javier Martínez-González, Marta Aicart Ramos, Paloma Bebia Conesa, María Isabel López-Espín, Enrique Pérez-Cuadrado Robles, Enrique Pérez-Cuadrado Martínez
Gastroenterología y Hepatología.2015; 38(1): 21. CrossRef
Vanek’s tumor of the small bowel in adults
Bassam Abboud
World Journal of Gastroenterology.2015; 21(16): 4802. CrossRef
Massive gastrointestinal bleeding caused by a giant gastric inflammatory fibroid polyp: A case report
Chenghai Zhang, Ming Cui, Jiadi Xing, Yunfei Shi, Xiangqian Su
International Journal of Surgery Case Reports.2014; 5(9): 571. CrossRef

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Diagnostic Agreement between Capsule Endoscopy and Double-balloon Enteroscopy of Small Bowel Disease: Hyun Gun Kim, M.D., Jin-Oh Kim, M.D., Tae Hee Lee, M.D., Wan Jung Kim, M.D., Hyun Sook Chol, M.D., Young Kwan Cho, M.D., Won Young Cho, M.D., Bong Min Ko, M.D., Joo Young Cho, M.D., Moon Sung Lee, M.D. and Joon Seong Lee, M.D.; Korean J Gastrointest Endosc 2010;40(4):236-243. Published online April 30, 2010

Abstract PDF: Background
/Aims: To evaluate the diagnostic agreement between capsule endoscopy (CE) and double-balloon enteroscopy (DBE) in patients with suspected small bowel disease.
Methods
We retrospectively analyzed and compared the diagnostic yield and the diagnostic agreement between CE and DBE, in patients who initially underwent CE followed by DBE at a single tertiary referral center.Results: Thirty patients (17 males, mean age 45±17) underwent both CE and DBE. Total small bowel examination was possible in 80% (24/30) with CE, and 20% (6/30) with DBE. Diagnostic yield was 56.7% (17/30) with CE, and 73.3% (22/30) with DBE. Overall diagnostic yield was 93.3% (28/30) after both examinations. The overall degree of concordance between CE and DBE for lesion description was a moderate agreement, with a calculated kappa index of 0.48 (95% CI 0.44∼0.52, p＜0.05). Both CE and DBE detected identical lesions relevant to the clinical presentation in 56.6% (17/30) of cases. A total of 36.7% (11/30) of cases changed diagnosis because different lesions were detected by each method.
Conclusions
The overall degree of concordance between CE and DBE showed moderate agreement. Additional DBE examinations can improve the diagnostic yield of small bowel lesions in patients with no relevant findings or failed detection on CE, who are, however, clinically suspicious. (Korean J Gastrointest Endosc 2010;40:236-243)

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A Clinical Analysis of Patients with Active Small Bowel Bleeding as Detected on Double Balloon Enteroscopy: Tae Hee Lee, M.D., Jin Oh Kim, M.D., Soo Hoon Eun, M.D., Bong Min Ko, M.D., Joo Young Cho, M.D., Joon Seong Lee, M.D., So Young Jin, M.D., Moon Sung Lee, M.D., Chan Sup Shim, M.D. and Boo Sung Kim, M.D.; Korean J Gastrointest Endosc 2008;37(5):321-327. Published online November 30, 2008

Abstract PDF: Background/Aims: There are few studies that have evaluated active small bowel bleeding. The aim of this study was to evaluate patients with active small bowel bleeding that had been considered as obscure gastrointestinal bleeding an was confirmed by the use of double balloon enteroscopy (DBE). Methods: We retrospectively reviewed the medical records of 12 patients with active small bowel bleeding as detected on DBE from January 2005 to September 2007. Results: The mean patient age was 63 years (age range, 45∼80 years) and the patients consisted of seven men and five women. The mean hemoglobin level at admission was 7.6 g/dL (range, 5.8∼9.0 g/dL). The mean transfusion volume was 4.4 pints (range, 0∼7 pints). Angiodysplasia was the most common cause of bleeding (n=6, 50%), followed by small bowel tumors (n=4, 33%). Other causes included diverticula and a nonspecific ulcer. The most common location of bleeding was the jejunum. Diagnostic yields of capsule endoscopy, a ^99mTc RBC scan, an abdomen CT scan, angiography and a small bowel series were 40%, 33%, 25%, 0% and 0%, respectively. Endoscopic treatment was performed successfully in eight patients (67%). Conclusions: The most common etiology for active small bowel bleeding is angiodysplasia followed by a small bowel tumor. Other diagnostic methods for the small bowel showed low diagnostic yields. Further investigation of active small bowel bleeding is needed to confirm our results. (Korean J Gastrointest Endosc 2008;37:321-327)

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A Case of a Cavernous Hemangioma in the Distal Jejunum Detected by Double-Balloon Enteroscopy in a Patient with Small Bowel Obstruction: Yu Jin Lim, M.D., Jin Lee, M.D., Jae Hoon Yang, M.D., Dong Hee Koh, M.D., Min Ho Choi, M.D., Hyun Joo Jang, M.D., Woo Young Jang, M.D.* and Sea Hyub Kae, M.D.; Korean J Gastrointest Endosc 2008;37(4):284-287. Published online October 30, 2008

Abstract PDF: Primary neoplasms of the small intestine are relatively rare. Early diagnosis and treatment of small bowel disease is difficult due to the low sensitivity of conventional examination methods. Double-balloon enteroscopy allows an exact examination of the small intestine, including a biopsy and other procedures, and the use of this technique provides an improvement in the diagnosis and treatment of small bowel disease. We report a case of a cavernous hemangioma of the distal jejunum that was detected by the use of double-balloon enteroscopy in a patient with recurrent periumbilical pain and small bowel obstruction that was treated by a small bowel segmental resection. (Korean J Gastrointest Endosc 2008;37:284-287)

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Diagnostic and Therapeutic Usefulness of Double Balloon Enteroscopy: Single Center Experience: Soo Hoon Eun, M.D., Jin-Oh Kim, M.D., Bong Min Ko, M.D., Keun Hyok Cho, M.D., Kyu Sung Chung, M.D., Joo Young Cho, M.D., Joon Seong Lee, M.D., Moon Sung Lee, M.D., Chan Sup Shim, M.D. and Boo Sung Kim, M.D.; Korean J Gastrointest Endosc 2008;36(2):64-70. Published online February 27, 2008

Abstract PDF: Background
/Aims: Until recently, only indirect procedures were available to provide images of the small bowel. Double-balloon enteroscopy (DBE) has the ability to obtain tissue for diagnosis and endoscopic interventions. This study was designed to determine the usefulness of DBE in patients with small bowel diseases by evaluating diagnostic yields and the impact on treatment. Methods: From November, 2004 to November, 2006 a total 81 patients with suspected small bowel disease were investigated by DBE. We analyzed the diagnostics and therapeutics rates according to the indications of DBE. Results: A total of 114 DBE procedures were performed. Gastrointestinal bleeding (64.2%) was the most common indication, followed by chronic abdominal pain/diarrhea (29.6%). A diagnosis was obtained in 44 of 52 patients with gastrointestinal bleeding and 17 of 24 patients with chronic abdominal pain/diarrhea. DBE resulted in therapeutic intervention in 17 patients with gastrointestinal bleeding and 13 patients with chronic abdominal pain/ diarrhea. DBE was diagnostic in 75.3% of the patients and played a role in the subsequent treatment of 37.0% of the patients. Conclusions: DBE was a useful and safe method for diagnosis and treatments in patients with small bowel diseases. (Korean J Gastrointest Endosc 2008;36: 64-70)

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A Case of Inflammatory Myofibroblastic Tumor Diagnosed with Double-balloon Enteroscopy: Hyun Gun Kim, M.D., Jin Oh Kim, M.D., Ik Sung Choi, M.D., Soo Hoon Eun, M.D., Bong Min Ko, M.D., Joo Young Cho, M.D., Joon Seong Lee, M.D., So Young Jin, M.D., Moon Sung Lee, M.D., Chan Sup Shim, M.D. and Boo Sung Kim, M.D.; Korean J Gastrointest Endosc 2008;36(2):97-101. Published online February 27, 2008

Abstract PDF: Gastrointestinal bleeding from an unknown origin occurs in 2∼10% of patients with a small bowel lesion. The recent developments in capsule endoscopy and double- balloon enteroscopy have helped improve the accuracy of a diagnosis of small bowel bleeding. Inflammatory myofibroblastic tumors are most often observed in the lungs of young adults but have rarely been reported in conjunction with a small bowel bleeding episode. We report a case of a bleeding inflammatory myofibroblastic tumor in the jejunum that had been diagnosed as non specific jejunal bleeding by capsule endoscopy and confirmed by double- balloon enteroscopy. (Korean J Gastrointest Endosc 2008;36:97-101)

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