Diagnostic yield of push enteroscopy in the investigation of small bowel disease

Authors K. Paraskeva, V. Vamvakousis, V. Balatsos, A. Konstantinidis, V. Ntelis, Z. Manika, N. Skandalis.


Aim: To assess the diagnostic value of push-type videoenteroscopy
in the investigation of small bowel disease.
Patients and methods: From January 1994 to November 2000,
235 consecutive patients underwent push-type enteroscopy,
using the Pentax, VSB 2900 video enteroscope. Indications
for enteroscopy were: unexplained iron deficiency
anaemia (n=59); macroscopic gastrointestinal bleeding
(n=49); abnormal small bowel radiology (n=12); chronic
diarrhoea and/or malabsorption (n=81); abdominal pain
(n=22); suspected neoplasia (n=7) and polyposis syndromes
Results: The median depth of small intestine intubated was
80 cm past the ligament of Treitz, (range 20-160cm). Procedure
time varied from 15-45 minutes. Tolerance of the
examination was good for all patients and there were no
complications. In patients with anaemia and/or gastrointestinal
bleeding, underlying pathology was detected in 64/108
patients (59%), while 19/108 patients (17.5%) had diagnostic
findings located in the upper gastrointestinal tract. In
those with abnormal small bowel radiology, abnormal findings
were diagnosed or excluded as artifacts in 11/12 patients
(91%). In those with diarrhea and/or malabsorption
a definite diagnosis was made in 28/81 patients (34.5%). In
patients with abdominal pain, abnormalities were detected
in 3/22 patients (13.5%). Finally, in patients with Peutz-
Jeghers syndrome push enteroscopy proved very sensitive in detecting jejunal polyps.
Conclusion: Push-type enteroscopy is a quick and
examination. Even though endoscopic exploration
restricted to the jejunum, it is efficacious in clinical practice
and provides valuable diagnostic information in
investigation of patients with small bowel disease.
Original Articles