Deep enteroscopy without the use of over-tube, balloons or fluoroscopy

Research output: Contribution to journalArticle

Abstract

Objective: Evaluation of the small bowel by double- balloon (DBE) and single balloon (SBE) is possible with the use of over tube. These methods are time consuming, require expensive new equipment and have potential for complications such as acute pancreatitis. We performed deep enteroscopy using a stiffening wire (PESW) and a 245 cm long enteroscope without over tube, balloons or fluoroscopy. Methods: A commercially available 245 cm long enteroscope (outer diameter 8.5 mm; biopsy channel 2.8 mm) and a stiffening wire 240 cm long were used. The procedure was performed with patient in left lateral position per oral route. The medications used were Midazolam (Mb), Fentanyl (F), and Diphenhydramine (DIPH). The scope was advanced by suction, stiffening, pushing pulling and mucosal slide by. Photodocumentation was obtained. For comparison with DBE data from a published report were used. Results: There were 30 patients; 17 men and 13 women. Mean age was 60.9 +/- 16 years. The indication for PESW were foreign body ingestion 3, abdominal pain 7, obscure GI bleeding 5, anemia 11, melena 4. The findings on PESW were: normal 15, celiac sprue 2, small bowel AVM 6, foreign body 3, carcinoma 1, Dieulafoy lesion 1, and small bowel ulcers 2. The mean duration of procedure was 31.5 +/- 7.2 minutes. The mean depth of insertion was 245.5 +/- 60 cms beyond Ligament of Treitz. Comparing the results with DBE obtained from a published report PESW was performed more quickly with comparable depth of insertion. There were no complications with PESW. Conclusions: PESW can be performed without over tubes, balloons, or fluoroscopy in a shorter time compared to DBE with a comparable depth of insertion beyond ligament of Treitz.

Original languageEnglish (US)
Pages (from-to)528-531
Number of pages4
JournalInternational Medical Journal
Volume20
Issue number5
StatePublished - Oct 2013

Keywords

  • Depth of insertion comparable to DBE
  • Enteroscope 245 cm long
  • Enteroscopy without overtube or balloons
  • Shorts duration
  • Stiffening wire 240 cm long

ASJC Scopus subject areas

  • Medicine(all)

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