A.W. Morrow Gastroenterology and Liver Centre, Royal Prince Hospital, Sydney, NSW, Australia.
Gastroenterology Consultant, A.W. Morrow Gastroenterology and Liver Centre, Royal Prince Hospital, Camperdown, Sydney, NSW 2050, Australia.
Therap Adv Gastroenterol. 2014 May;7(3):108-14. doi: 10.1177/1756283X13513995.
There is little data on the role of balloon enteroscopy and small bowel strictures. We aim to characterize the diagnostic role of double balloon enteroscopy (DBE) in small bowel strictures and document the outcomes of dilatation.
This is a retrospective review from a single tertiary referral centre DBE database from July 2004 to September 2012. All patients with suspected strictures in the small bowel undergoing DBE were included. The position of the small bowel strictures considered for dilatation was determined by diagnostic imaging, i.e. CT enterography, MR enterography or capsule endoscopy in the workup before DBE. Endpoints included stricture description, dilatation parameters and response to treatment. Main outcome measurements were the safety and efficacy of DBE and dilatation.
From our DBE database of 594 patients, a total of 32 patients underwent 44 DBE procedures for suspected or known strictures. Stricture aetiology included Crohn's disease (CD), nonsteroidal anti-inflammatory drugs (NSAIDs), surgical, Beçhets disease and one unknown. A total of 17 patients did not undergo dilatation as the strictures were ulcerated, nonobstructing or of uncertain aetiology. From the total of 25 dilatations in 15 patients that were attempted, 8/15 (53%) patients had 1 dilatation, 5 patients had 2 dilatations, 1 had 3 dilatations and 1 had 4 dilatations. The mean dilatation diameter was 14 mm. Three patients underwent surgery post-dilatation (2 for perforation). Mean follow up was 16 months.
DBE is a useful method in determining the need for dilatation by assessing for active ulceration. Dilatation is effective in the 10-18 mm range, however perforation does occur.
关于球囊式小肠镜和小肠狭窄的作用，相关数据较少。本研究旨在阐述双气囊小肠镜（DBE）在小肠狭窄中的诊断作用，并记录扩张术的效果。
这是对 2004 年 7 月至 2012 年 9 月单中心的 DBE 数据库进行的回顾性研究，所有疑似小肠狭窄并接受 DBE 检查的患者均被纳入。根据诊断性影像学检查（如 CT 肠造影、磁共振肠造影或胶囊内镜）来确定行 DBE 前的小肠狭窄部位是否需要扩张。观察指标包括狭窄描述、扩张参数和治疗反应。主要的测量结果为 DBE 和扩张的安全性和有效性。
在我们的 594 例 DBE 患者数据库中，共有 32 例患者因疑似或已知的狭窄接受了 44 次 DBE 检查。狭窄的病因包括克罗恩病（CD）、非甾体抗炎药（NSAIDs）、手术、贝切特病和 1 例不明原因。由于狭窄为溃疡性、非梗阻性或病因不明，共有 17 例患者未进行扩张。在总共 25 例对 15 例患者尝试的扩张中，8/15（53%）患者进行了 1 次扩张，5 例患者进行了 2 次扩张，1 例患者进行了 3 次扩张，1 例患者进行了 4 次扩张。平均扩张直径为 14 毫米。3 例患者在扩张后接受了手术（2 例因穿孔）。平均随访时间为 16 个月。
DBE 通过评估活动性溃疡来确定是否需要扩张，是一种有用的方法。在 10-18 毫米范围内扩张是有效的，但确实会发生穿孔。
