[Double-balloon enteroscopy: experience in the Hospital de Especialidades del Centro Médico Nacional Siglo XXI IMSS, Mexico City].

UNLABELLED

The methods used for the study of the small bowel are not ideal. Double-balloon enteroscopy is a new alternative with therapeutic potential.

OBJECTIVE

Evaluate the utility, efficacy and safety of double-balloon enteroscopy in Mexico.

MATERIAL AND METHODS

Adult patients seen in the Hospital de Especialidades Centro Médico Nacional Siglo XXI, Mexico City who were being studied for: chronic diarrhea, obscure gastrointestinal hemorrhage, weight-loss and chronic anemia were included in the study. Anterograde (oral) and retrograde (anal) approaches were used and study time, findings and complications were evaluated.

RESULTS

Thirty-one enteroscopies were performed, 15 were anterograde, 8 retrograde and 8 were performed via both routes, in 23 patients studied between February and October, 2004; 10 of them were women and 13 men with ages ranging from 25 to 80 years. Fourteen patients were sedated and 9 patients were anesthetized. Study time varied form 55 to 90 minutes. With the anterograde route the ileum was reached in 56.6% of cases, 39.1% the jejunum and only in one patient (4.3%) the whole intestine was explored. With the retrograde route in 62.5% of cases the jejunum was explored and 37.5% the ileum. Four patients with obscure gastrointestinal bleeding and 1 patient with chronic anemia had vascular ecstasies, and in 40% of patients there was no identifiable cause. In 2 patients with intestinal stenosis biopsies revealed intestinal lymphoma in one and ischemic injury in another one. The adverse effects were mild and transitoru.

CONCLUSIONS

Double-balloon enteroscopy is a safe diagnostic and therapeutic method that is useful in cases of obscure hemorrhage, chronic anemia; small bowel pathology was found in 64.7% of cases.