Evaluation of small bowel wall thickness with double balloon enteroscopy

Abstract

Objectives: Double balloon enteroscopy (DBE) is an endoscopic method used for the evaluation of small bowel segments. Its advantage over other small bowel evaluation methods is that it allows treatment in addition to the detection of lesions. In this study, we evaluated the results of patients with small bowel abnormalities, especially wall thickness, on radiologic imaging who underwent double-balloon enteroscopy. Methods: The data of patients who were found to have wall thickness and stenosis in the small intestine on radiological imaging and who underwent DBE between January 2007 and December 2018 at Ankara City Training and Research Hospital were retrospectively analyzed. Patients with inadequate endoscopic images or medical records were excluded from this study. Results: The study included 112 patients. Of the patients, 69 (61.6%) were male and 43 (38.4%) were female. The mean age of the population was 45.59 ± 17 years. Abdominal pain was the main presenting symptom. The procedure was performed anterograde (oral) in 79 patients, retrograde (anal) in 25 patients, and both approaches in 8 patients. Various complications developed after 20 procedures, and no mortality was observed. Radiologically, small bowel wall thickness was most commonly detected on computed tomography, and the majority of the lesions detected were in the jejunum (63.9%). In 48 DBE procedures, no lesion was detected in the small intestine. The ulcer was the most common lesion detected during DBE (25.6%), and the majority were detected in the ileum. Crohn's disease was the most common pathology detected in the samples. Malignancy was the second most common pathology, and jejunal lymphoma was the most common malignancy. Conclusion: DBE should be used more frequently in clinical practice to evaluate radiologically detected small bowel lesions because of the possibility of biopsy and its high diagnostic accuracy.