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

Abstract

SUMMARY
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
(n=5).
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.