Diagnostic Value Of Double-balloon Enteroscopy In Identifying Small Intestinal Diseases

Objective: Because of its anatomy and physiological characteristics: long,twists,location is not fixed and the cause is complex.It confines the diagnosing ability and the localization of traditional inspection methods and restricts the deep intubation of endoscopy.Therefore,the diagnosis of small intestinal diseases is relatively difficult.Patients of suspected small intestinal diseases were performed by barium meal and computer tomography(CT)or capsule endoscope(CE)and DBE in our study.Analyze the diagnostic value and pathological lesions.Compare the detective yield and diagnostic yield of the four methods.Estimate the safety of DBE.Observe the patients’ tolerance and complications.Estimate the clinical practicality of DBE generally.Methods:We studied 73 patients during January 2013 to December 2015 in our hospital.The suspected small intestinal disease patients who did gastroscope,colonoscopy and other routine inspection and found no positive diagnosis underwent DBE.Analyze pathological type,detective yield and diagnostic yield.Compare the detective yield and diagnostic yield of CE,barium meal and abdomen CT.Estimate the safety.Results: 77 DBE procedures wre performed in 73 patients who were not under the anesthesia,31 of them wre performed by oral and 42 by anal route.59 cases(59/73)with small bowel lesions were detected by DBE examination.Most findings are crohn’s disease,then enteritis,tumor,small intestinal ulcer.There were crohn’s disease 17cases(28.7%),enteritis 9 cases(15.3%),then tumor 8 cases(13.5%),small intestinal ulcer 7 cases(11.9%),small intestinal polyp 7 cases(11.9%)etc.The lesion detection rate of DBE,capsule endoscope,abdomen CT,barium meal were 76.6%,75%,53.8%,42.1%.The lesion detection rate in obscure gastrointestinal bleeding,chronic abdominal pain,chronic diarrhea,incomplete intestinal obstruction were 88.9%,61.9%,77.8%,91.9%.In the process of operation and postoperative,a part of the patients could feel slight abdominal pain and abdominal distention.No perforation,henmorrhage,acute pancreatitis,aspiration pneumonia or other serious complications happened,include all patients with endoscopic biopsy.Conclusion: There is a high diagnosis and safety on DBE which is a useful tool to diagnosis the small bowel diseases.And it is worthy of clinical popularization and application.