double-balloon enteroscopy: a descriptive study of 50 explorations enteroscopia de doble balón: estudio descriptivo de 50 exploraciones

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ID: 185423
2006
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Abstract
Aim: to evaluate the utility of double-balloon enteroscopy for small-bowel disease. Design: a prospective study of 50 consecutive enteroscopies performed from December 2004 to July 2005 to analyze diagnoses and treatments. Patients: 44 patients (33 had undergone a previous capsule endoscopy) with indications for obscure digestive hemorrhage, angiodysplasia, Peutz-Jeghers syndrome, ulcer, suspected Crohn's disease, tumors, and refractory celiac disease. Results: we carried out enteroscopy studies in 44 patients by the oral route and, in 6 additional patients, by both the oral and anal routes. We reached the ileon with the oral route in all cases but one (jejunal stenosis), and in 4 cases out of 7 with the anal route, with an average duration of 73 minutes. We found angiodysplasia in 19 cases, as well as NSAID-related enteropathy, Crohn's disease, diverticulosis, and Waldenström's disease. We performed biopsies in 31% of cases with diagnoses of adenocarcinoma, lymphangiectasia secondary to tumor in celiac disease, and Whipple's disease. We treated 19 patients with angiodysplasia (1 to 20 synchronous lesions) with argon, and 4 patients with polyps using polipectomy (sporadic polyps or Peutz-Jeghers syndrome). A retained capsule in one patient with stenosis was removed. Conclusions: double-balloon enteroscopy is a useful and effective technique in the diagnosis and treatment of small intestine diseases, thus complementing capsule endoscopy. More studies are needed to analyze its impact on the management of this condition.
Objetivo: valorar la utilidad de la enteroscopia de doble balón en enfermedades de intestino delgado. Diseño: estudio prospectivo descriptivo de 50 enteroscopias consecutivas (diciembre 2004 a julio 2005), analizando diagnóstico y terapéutica. Pacientes: cuarenta y cuatro pacientes (33 con cápsula endoscópica previa) con hemorragia digestiva oculta o lesiones detectadas mediante cápsula (angiodisplasias, pólipos, úlceras, enfermedad de Crohn, celiaca refractaria y tumores). Resultados: se realizó enteroscopia vía oral a 44 pacientes y vía oral más anal a 6. Por vía oral se progresó hasta íleon en todos los casos excepto uno (estenosis yeyunal), por vía anal en 4 de 7 (3 casos con dificultad de paso por Bahuin). La duración media fue 73 minutos. Se detectaron angiodisplasias (19 casos), úlceras en enteropatía por AINE, enfermedad de Crohn, enfermedad de Waldenström, y divertículos. Se realizaron biopsias en yeyuno-íleon en un tercio de los casos (adenocarcinoma, linfangiectasias secundarias a tumor sobre celíaca, enfermedad de Whipple). Se realizó terapéutica con argón a 19 pacientes con angiodisplasias (1 a 20 lesiones), polipectomía a 4 pacientes con pólipos esporádicos o Peutz Jeghers (1 a 15 pólipos) y se extrajo una cápsula endoscópica retenida en una estenosis. Conclusiones: la enteroscopia de doble balón es una técnica útil y eficaz en el diagnóstico y tratamiento de las lesiones del intestino delgado, complementando a la cápsula endoscópica. Hacen falta más estudios para analizar el impacto esperado en el cambio del manejo de estos pacientes.
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Authors E. Pérez-Cuadrado, P. Más, H. Hallal, J. Shanabo, E. Muñoz, I. Ortega, A. López Martín, E. Torrella, A. López Higueras, A. Martín, F. Carballo
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Journal chemistry of heterocyclic compounds
Year 2006
DOI
DOI not found
URL
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006000200002
Keywords
Gastroenterology

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