Single-balloon enteroscopy in management of small-bowel disorders
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ORIGINAL ARTICLE
Single-balloon enteroscopy in management of small-bowel disorders Mahesh Kumar Goenka 1 & Shivaraj Afzalpurkar 1 & Vijay Kumar Rai 1 & Rachit Agarwal 1 & Bhavik Bharat Shah 1 & Gajanan Ashokrao Rodge 1 & Bhageerath Raj 1 & Usha Goenka 2 Received: 17 March 2020 / Accepted: 31 August 2020 # Indian Society of Gastroenterology 2020
Abstract Background Device-assisted enteroscopy including single-balloon enteroscopy (SBE) allows direct visualization of the small bowel and has good safety and efficacy in experienced hands. Our study is aimed to share our single-centre experience of SBE in diagnosing and treating small-bowel disorders. Methods We reviewed the prospectively collected data (from December 2016 to December 2019) of 180 consecutive anterograde and/or retrograde procedures. Analysis of baseline characteristics, endoscopic findings, and diagnostic and therapeutic rates was done. Results SBE was done in 158 patients with a median age of 55 years (range, 13–94 years) for suspected small-bowel lesions. Dual enteroscopy (anterograde plus retrograde) was done in 22 patients (13.92%). The indication for the procedure was obscure gastrointestinal bleeding in 129 (71.66%), chronic unexplained abdominal pain in 20 (11.11%), suspected small-bowel abnormality in the form of narrowing and/or mass on imaging in 10 (5.5%), chronic diarrhea in 9 (5%), unexplained iron deficiency anemia in 9 (5%), and retained capsule in 2 (1.11%). The most common finding was ulcer, which was noted in 45 (25%) patients followed by stricture in 8 (4.44%) and both ulcers and strictures in 6 (3.33%) patients. SBE was normal in 61 (33.88%) patients. SBE gave a diagnosis in 66.11% while in 28.43% cases, therapeutic intervention was done. Minor complications like bleeding were noted in 3 patients and mild acute pancreatitis in 2 patients. Jejunal perforation requiring surgical intervention was noted in 1 patient. Conclusion SBE is a safe and effective procedure in diagnosing and treating small-bowel diseases. Keywords Antegrade enteroscopy . Capsule endoscopy . Iron deficiency anemia . Obscure gastrointestinal bleed . Retrograde enteroscopy . Single-balloon enteroscopy . Small bowel . Spirus enteroscopy
Introduction Endoscopic observation of the entire small intestine and subsequent management without surgery have been possible since the discovery of double-balloon enteroscopy (DBE) by Yamamoto et al. [1]. In 2007, Olympus Medical Systems (Tokyo, Japan) launched the single-balloon enteroscopy (SBE) as an alternative to DBE [2–4]. The preparation and procedure time somewhat shortened by the application of one instead of two balloons. Direct visualization of the whole small intestinal mucosa became * Mahesh Kumar Goenka [email protected] 1
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possible in 2001 with the introduction of capsule endoscopy [5]. However, tissue sampling and therapeutic interventions are major limitations with capsule endoscopy. The data on the safety and efficacy of balloon-assisted enteroscopy has been analyzed and published regularly since its intro
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