WHICH IS BETTER, TO STOP BALLOON ASSISTED ENTEROSCOPE ON FINDING A LESION OR TO COMPLETE AS FAR AS POSSIBLE “A CASE SERIES STUDY”

Aims:

Balloon-assisted enteroscopy (BAE) is an advanced procedure to evaluate the entire small bowel. It allows better visualization, biopsy from the identified lesions and application of therapeutic techniques, BAE is a novel time consuming procedure. it require validation of criteria for successful examination. The aim of our study is to evaluate the feasibility and usefulness of continuing enteroscope as far as possible after a finding lesion that explains the clinical presentation.

Methods:

We retrospectively assessed our experience with BAE during a 6-years period, 128 procedure were performed (91 antegrade and 37 retrograde procedures) using the SIF-Q180 Olympus and Fujinon EG-450 E5 in the Endoscopy Unit at Internal Medicine Department, Faculty of Medicine, Cairo University.

Results:

41 patients (31%) have no lesions, 61 patients (48%) examination ended on finding a lesion that explains the indication of the procedure, in the last group 26 patients (21%) had proximal jejunal lesions so it was feasible to continue afterwards and it was surprising to find another lesion in 5 patient; the first patient had scalloping jejunal folds later confirmed celiac disease after 3 meters we found another lesion biopsy revealed adenocarcinoma, in the second patient proximal lesion was adenocarcinoma and after 150 cm bronchogenic carcinoma metastasis was found, third patient had two synchronous adenocarcinoma one meter apart, the fourth patient had celiac disease and deep tuberculous ulcer and last patient had scattered telangiectasia and ectopic jejunal varix.

Conclusions:

Even if you find a culprit lesion we recommend to continue as far as possible, regarding BAE Some aspect remain unanswered, so there is a great need for prospective study to better assess the benefit and risk of total small bowel examination.