How effective is enteroscopy?

The small bowel can be successfully investigated by enteroscopy techniques. Several types of enteroscopes with different technical characteristics have been developed. In this paper we explain the respective advantages and disadvantages of the different techniques. Results of several series using these two enteroscopes are summarized and commented. The review of different series make clear that enteroscopes, especially those including an operating channel represent an attractive alternative diagnostic tool to angiography and small bowel barium studies in patients presenting obscure digestive bleeding. The series reviewed in this paper confirm the high diagnostic efficacy of this type of endoscopy. Most of the lesions found are arteriovenous malformations especially in the elderly. Small bowel tumours are more likely to be found in younger patients. New indications for enteroscopy should be evaluated carefully. Obscure digestive bleeding represents the main indication of enteroscopy. However clinical situations suggesting Crohn's disease or malabsorption syndromes may be effectively evaluated by this special endoscopic technique.