Division of Gastroenterology, The University of Western Ontario, London, Ontario, Canada.
Division of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington, USA.
Gastrointest Endosc. 2015 Jul;82(1):102-7. doi: 10.1016/j.gie.2014.12.039. Epub 2015 Apr 1.
Double-balloon enteroscopy (DBE) is effective in visualizing the small bowel to perform biopsy sampling and interventions. Few studies have evaluated the utility of DBE in patients with known or suspected Crohn's disease (CD).
To evaluate the use of DBE in the diagnosis and impact on patient management in known and suspected CD and to compare capsule endoscopy (CE) with DBE findings.
Retrospective study from August 2004 to August 2009 of DBE procedures.
Five academic, tertiary U.S. centers.
Patients with known or suspected CD.
Diagnostic yield, impact on patient management, and comparison of DBE to CE findings in patients with known and suspected CD.
We analyzed 98 DBE procedures performed in 81 patients (38 with known CD and 43 with suspected CD). For patients with CD, common indications were abdominal pain and bleeding/anemia. The diagnostic yield was 87% (33/38 patients). The impact on subsequent management decisions was 82% (31/38). Common indications for DBE in patients with suspected CD were abnormal CE or other imaging. The diagnostic yield was 79% (34/43 patients). The impact on subsequent management decisions was 77% (33/43). In 17% of patients (14/81), DBE failed to reach the target lesion. There was 1 perforation, 3 strictures dilated, and 1 of 2 retained capsules recovered. When CE was followed by DBE, 46% of lesions were confirmed on DBE.
Retrospective analysis, imperfect criterion standard.
DBE is an effective technique for assessment of the small bowel in known and suspected CD and affects management. Failure to reach target areas with DBE is not uncommon, and perforations can occur. There is poor correlation between CE and DBE.
双气囊小肠镜（DBE）在可视化小肠以进行活检采样和干预方面非常有效。很少有研究评估 DBE 在已知或疑似克罗恩病（CD）患者中的效用。
评估 DBE 在已知和疑似 CD 中的诊断价值及其对患者管理的影响，并比较胶囊内镜（CE）与 DBE 检查结果。
2004 年 8 月至 2009 年 8 月 DBE 程序的回顾性研究。
美国五所学术性三级医院。
已知或疑似 CD 的患者。
诊断率、对患者管理的影响，以及在已知和疑似 CD 患者中 DBE 与 CE 检查结果的比较。
我们分析了 81 例患者（38 例已知 CD 和 43 例疑似 CD）的 98 例 DBE 操作。对于 CD 患者，常见的适应证是腹痛和出血/贫血。诊断率为 87%（33/38 例）。对后续管理决策的影响为 82%（31/38 例）。疑似 CD 患者进行 DBE 的常见适应证是 CE 或其他影像学异常。诊断率为 79%（34/43 例）。对后续管理决策的影响为 77%（33/43 例）。在 17%的患者（14/81）中，DBE 未能到达目标病变部位。有 1 例穿孔，3 例狭窄扩张，2 例中仅 1 例胶囊被取出。CE 后行 DBE 时，46%的病变在 DBE 上得到确认。
回顾性分析，不完全的标准。
DBE 是评估已知和疑似 CD 患者小肠的有效技术，可影响治疗管理。DBE 未能到达目标区域的情况并不少见，且可能发生穿孔。CE 与 DBE 之间相关性差。
