Landi B, Tkoub M, Gaudric M, Guimbaud R, Cervoni J P, Chaussade S, Couturier D, Barbier J P, Cellier C
Laennec Hospital, Paris, France.
Gut. 1998 Mar;42(3):421-5. doi: 10.1136/gut.42.3.421.
Push-type enteroscopy, a recent method for investigating the small intestine, is currently undergoing assessment. Its diagnostic yield varies in the studies reported to date.
To assess the diagnostic value of push-type enteroscopy according to indication.
From January 1994 to September 1995, 152 consecutive patients (mean age 34 years) underwent push-type enteroscopy (jejunoscopy, n = 93; retrograde ileoscopy, n = 17; and double way enteroscopy, n = 42). The indications were: unexplained iron deficiency anaemia or macroscopic gastrointestinal bleeding (n = 76), radiological abnormalities of the small intestine (n = 23), chronic diarrhoea and/or malabsorption syndrome (n = 18), abdominal pain (n = 12), and miscellaneous (n = 23). All patients had undergone previous negative aetiological investigations.
The jejunum and ileum were explored through 120 cm (30-160 cm) and 60 cm (20-120 cm). Digestive bleeding: lesions of the small bowel were found in 6% of the patients with isolated iron deficiency anaemia and 20% of patients with patent digestive haemorrhage. Radiological abnormalities of the small intestine: push-type enteroscopy provided a diagnosis or modified the interpretation of radiological findings in 18/23 cases (78%). Chronic diarrhoea and/or malabsorption: push-type enteroscopy yielded explanatory findings in four cases (22%). Abdominal pain: push-type enteroscopy provided no diagnosis.
In this series, push-type enteroscopy was of particular value in investigating patients with radiological abnormalities of the small intestine. It was of some value in the exploration of patent digestive haemorrhage or chronic diarrhoea, but not of abdominal pain. Its value was limited in the exploration of iron deficiency anaemia.
推进式小肠镜检查是一种用于小肠检查的新方法，目前正在评估中。在迄今报道的研究中，其诊断率各不相同。
根据适应证评估推进式小肠镜检查的诊断价值。
1994年1月至1995年9月，连续152例患者（平均年龄34岁）接受了推进式小肠镜检查（空肠镜检查93例；逆行回肠镜检查17例；双向小肠镜检查42例）。适应证包括：不明原因的缺铁性贫血或肉眼可见的胃肠道出血（76例）、小肠放射学异常（23例）、慢性腹泻和/或吸收不良综合征（18例）、腹痛（12例）以及其他（23例）。所有患者此前的病因学检查均为阴性。
空肠和回肠的探查长度分别为120厘米（30 - 160厘米）和60厘米（20 - 120厘米）。消化性出血：在单纯缺铁性贫血患者中，小肠病变的发现率为6%，在有明显消化性出血的患者中为20%。小肠放射学异常：推进式小肠镜检查在18/23例（78%）中提供了诊断或修正了对放射学检查结果的解释。慢性腹泻和/或吸收不良：推进式小肠镜检查在4例（22%）中得出了解释性结果。腹痛：推进式小肠镜检查未提供诊断。
在本系列研究中，推进式小肠镜检查在小肠放射学异常患者的检查中具有特殊价值。在明显消化性出血或慢性腹泻的探查中具有一定价值，但对腹痛检查无价值。其在缺铁性贫血探查中的价值有限。
