scholarly journals A130 VIDEOCAPSULE ENDOSCOPY VERSUS DOUBLE-BALLOON ENTEROSCOPY: WHICH ONE WINS?

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 113-114
Author(s):  
S Li Fraine ◽  
C Langevin ◽  
N Mahdi ◽  
M Bouin
Keyword(s):  
Diagnostic Performance ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Small Intestinal Mucosa ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Iron Deficient ◽  
First Choice ◽  
Videocapsule Endoscopy

Abstract Background Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are two endoscopic exams that permit the investigation of the small intestinal mucosa. There exists few studies that compare the diagnostic performance and results between these two diagnostic modalities. Aims To compare the diagnostic performance between VCE and DBE. Methods Retrospective study between 2016 and 2019. All patients at a tertiary care centre undergoing both VCE and DBE were recruited. Clinical and endoscopic information was compiled from patients’ medical charts as well as the indications and results of the two endoscopic exams. The patients with an incomplete endoscopy report or who were unable to complete both VCE and DBE were excluded. The results of both VCE and DBE were compared using univariate analysis. Results In total, 126 patients underwent VCE. Of those patients, 15 further underwent DBE (average age: 69±17, 53% female). In total, 11 patients underwent upper DBE, 3 patients underwent lower DBE, and one patient underwent both upper and lower DBE. The indications for endoscopy were: gastrointestinal bleeding (47%), iron deficient anemia (40%), and other (13%). The VCE findings were: angiodysplasia (35%), inflammation (35%), polyp/neoplasia (20%), and other (10%). The DBE findings were: angiodysplasia (41%), normal (35%), polyp/neoplasia (12%), stenosis (6%) and other (6%). In 53% of cases there was at least one finding concordant between VCE and DBE. In only 20% of cases, DBE found a new lesion that was not seen by VCE. In comparison, 33% of DBE exams were normal despite a positive findings by VCE. The discordance between exams was possibly due to the delay between both exams (average 125 days). Conclusions In over half of cases, there is at least one lesion consistent between both endoscopic modalities. DBE finds a new lesion that was not seen by VCE in only 20% of cases. Therefore, VCE should be the first choice in the investigation of the small intestine mucosa even though both exams seem to be complementary. Funding Agencies None

scholarly journals Predictors for outcomes and readmission rates following double balloon enteroscopy: a tertiary care experience

2018 ◽  
Vol 06 (06) ◽  
pp. E751-E757 ◽  
Author(s):  
Danielle Shelnut ◽  
Omar Sims ◽  
Jenine Zaibaq ◽  
Hyejung Oh ◽  
Krishna Venkata ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Diagnostic Yield ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Deficiency Anemia ◽  
Readmission Rates ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Procedural Time

Abstract Aim The objectives of this study are to examine clinical characteristics of patients undergoing anterograde and retrograde double balloon enteroscopy (DBE) and to assess factors predicting positive diagnostic yield, therapeutic yield, and readmission. Methods We conducted a retrospective cohort study of patients (n = 420) who underwent DBE at a tertiary care center between 2012 and 2016 at a tertiary referral center. Measures of central tendency and frequency distributions were used for univariate analysis. Chi-square and t-test analyses were used to compare patient characteristics. Logistic regression was used to predict outcomes of interest. Results Of patients included in the study, 59 % were male with a mean age of 61.49 (SD = 15.15) Altered anatomy was noted in 14 %, while 5 % and 13 % of patients had end stage renal disease (ESRD) and current use of anticoagulation, respectively. The most common indication for DBE was obscure gastrointestinal bleed (OGIB) (33 %). Forty-nine patients had obscure and overt gastrointestinal bleeding (GIB) and 22 % had occult GIB with iron deficiency. The cohort’s rate of positive diagnostic yield was 73 % and 35 % for therapeutic yield. The 30-day and 6-month readmission rates were both 11 %. A higher proportion of those readmitted were male (75 % vs 57 %, P = 0.027) and had longer procedural time (38.68 vs 46.57, P = 0.011). Likewise, occult GIB with iron deficiency anemia and iron deficiency alone (OR = 2.45, CI: 1.233 – 4.859, P = 0.011), inpatient status (OR 2.42, CI 1.344 – 4.346, P = 0.003), and longer procedural time (OR = 1.02, CI: 1.004 – 1.029, P = 0.008) were associated positively with readmission. There were no statistically significant predictors of positive diagnostic yield, however procedural time (OR = 1.01, CI: 1.03 – 1.026; P = .0017) and older age (OR = 1.03, CI: 1.009 – 1.045, P = 0.003) were positively associated with therapeutic yield. Retrograde procedure (OR = 0.230, CI 0.125 – 0.422, P = 0.000) was negatively associated with therapeutic yield. Conclusion DBE procedures have relevant efficacy for both diagnostic and therapeutic yield while evaluating small bowel disease. Readmission rates are low and more in those with GI bleed and iron deficiency with longer index procedural times.

scholarly journals Comparison of Capsule Endoscopy Findings to Subsequent Double Balloon Enteroscopy: A Dual Center Experience

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Amandeep S. Kalra ◽  
Andrew J. Walker ◽  
Mark E. Benson ◽  
Anurag Soni ◽  
Nalini M. Guda ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Tertiary Care ◽  
Kappa Statistics ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Gastrointestinal Blood Loss ◽  
Contingency Coefficient ◽  
Kappa Value ◽  
The Mean

Background. There has been a growing use of both capsule endoscopy (CE) and double balloon enteroscopy (DBE) to diagnose and treat patients with obscure gastrointestinal blood loss and suspected small bowel pathology. Aim. To compare and correlate sequential CE and DBE findings in a large series of patients at two tertiary level hospitals in Wisconsin. Methods. An IRB approved retrospective study of patients who underwent sequential CE and DBE, at two separate tertiary care academic centers from May 2007 to December 2011, was performed. Results. 116 patients were included in the study. The mean age ± SD was 66.6 ± 13.2 years. There were 56% males and 43.9% females. Measure of agreement between prior capsule and DBE findings was performed using kappa statistics, which gave kappa value of 0.396 with P<0.001. Also contingency coefficient was calculated and was found to be 0.732 (P<0.001). Conclusions. Our study showed good overall agreement between DBE and CE. Findings of angioectasia had maximum agreement of 69%.

scholarly journals Diagnostic efficacy of double-balloon enteroscopy in patients with suspected isolated small bowel Crohn’s disease

2019 ◽  
Author(s):  
Zihan Huang ◽  
Xiang Liu ◽  
Fei Yang ◽  
Guoxin Wang ◽  
Nan Ge ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Abdominal Mass ◽  
Video Capsule Endoscopy ◽  
Small Intestinal Mucosa ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Abstract Background Due to the development of double-balloon enteroscopy and video capsule endoscopy, direct visualization of the entire small intestinal mucosa has been achieved. Compared with video capsule endoscopy, double-balloon enteroscopy has the advantages of biopsy samples and endoscopic treatment. The aim of this research was to explore the value of double-balloon enteroscopy for isolated small bowel Crohn’s disease. Methods This study included patients with suspected isolated small bowel Crohn’s disease who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients with symptoms of chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic Crohn’s disease were excluded from this cohort. Patients with suspected isolated small bowel Crohn’s disease underwent double-balloon enteroscopy. Results With clear endoscopic images and histological support, 14 patients were diagnosed with isolated small bowel Crohn’s disease. Three patients who were diagnosed with small bowel Crohn’s disease by double-balloon enteroscopy showed improved morphological features of the small bowel when the double-balloon enteroscopy was reviewed after medical treatment. Conclusions The diagnosis of Crohn’s disease is usually based on the patient’s clinical history and related examinations. Double-balloon enteroscopy provides imaging support and histological support for the definitive diagnosis of Crohn’s disease and can be considered as a useful tool to evaluate the therapeutic efficacy in the future.

Su1200 Outcomes of Double Balloon Enteroscopy: A 4-Year Experience at a Tertiary Care Center

2017 ◽  
Vol 85 (5) ◽  
pp. AB311-AB312
Author(s):  
Danielle J. Shelnut ◽  
Krishna V. Venkata ◽  
Jenine N. Zaibaq ◽  
Hyejung Oh ◽  
Omar T. Sims ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon

scholarly journals Diagnostic efficacy of double-balloon enteroscopy in patients with suspected isolated small bowel Crohn’s disease

2020 ◽  
Author(s):  
Zihan Huang ◽  
Xiang Liu ◽  
Fei Yang ◽  
Guoxin Wang ◽  
Nan Ge ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Abdominal Mass ◽  
Experimental Treatment ◽  
Small Intestinal Mucosa ◽  
Double Balloon Enteroscopy ◽  
Diagnostic Efficacy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Abstract Background: Owing to the development of double-balloon enteroscopy (DBE) and video capsule endoscopy (VCE) in recent years, direct visualization of the entire small intestinal mucosa has become possible. Because of the nonspecific symptoms and the anatomic location of the small bowel, diagnosis of isolated small bowel Crohn’s disease (CD) remains a challenge. The aim of this research was to explore the value of DBE for isolated small bowel CD in situations where routine tests cannot confirm the diagnosis.Methods: This study included patients with suspected isolated small bowel CD who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients presenting with chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic CD were excluded from this cohort. Patients with suspected isolated small bowel CD underwent DBE.Results: In 16/18 patients, pathological findings were detected by DBE. In 12 of the cases, small bowel CD was confirmed. The remaining four patients were diagnosed with small bowel inflammation, duodenal carcinoma, ileum inflammation and small bowel ulcers. However, the diagnosis of CD was confirmed in 14/18 (78%) patients by taking into account the clinical presentation, endoscopic and histological results as well as the experimental treatment. DBE assisted in the diagnosis in 86% (12/14) of the patients.Conclusions: In the diagnosis of small bowel CD, DBE is a helpful tool. Before assessment with DBE, clinical features, colonoscopy, and CT were used to initially assess the intestine. According to the lesions indicated by CT, we chose the most appropriate endoscope insertion route, and combined the endoscopic characteristics and pathological results of DBE to confirm the diagnosis.

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