Endoscopy 2010; 42(11): 926-933
DOI: 10.1055/s-0030-1255810
DDW highlights

© Georg Thieme Verlag KG Stuttgart · New York

Small-bowel endoscopy

M.  Pennazio1
  • 1Division of Gastroenterology 2, Department of Medicine, S. Giovanni AS University Teaching Hospital, Turin, Italy
Further Information

Publication History

Publication Date:
11 November 2010 (online)

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Introduction

The past decade has seen a revolution in small-bowel endoscopy. The significant advance in diagnostic ability introduced by capsule endoscopy has prompted interest in further improvements in diagnostic capability, as well as new methods to treat the lesions identified. Capsule endoscopy was quickly followed by double-balloon enteroscopy (DBE), which offered new therapeutic options. Technical progress has continued to be rapid, such that we now have the so-called device-assisted enteroscopy (DAE), which includes DBE, single-balloon enteroscopy (SBE), and spiral enteroscopy, through which diagnostic and therapeutic interventions are available.

A total of 112 scientific contributions on small-bowel endoscopy were presented at Digestive Disease Week this year (DDW 2010; 1 – 5 May, New Orleans, Louisiana, USA). Although this volume of work testifies to the fact that researchers’ interest in small-bowel endoscopy is high, very few prospective studies were presented. Obscure gastrointestinal bleeding (OGIB) remains the most consolidated indication for small-bowel endoscopy. For other indications, the level of evidence is lower, reflecting the paucity of randomized controlled trials (RCTs). Various reports addressed technical aspects of small-bowel endoscopy and innovations, the remote manipulation of wireless capsule endoscopes being one of the most exciting ongoing lines of research.

References

  • 1 Teshima C W, Kuipers E J, van Zanten S V, Mensink P. Double balloon enteroscopy and capsule endoscopy for obscure gastrointestinal bleeding: an updated meta-analysis.  Gastrointest Endosc. 2010;  71 AB249
  • 2 Van Weyenberg S J, Van Turenhout S T, Jacobs M A. et al . Continuation of anticoagulant therapy in patients with overt obscure gastrointestinal bleeding increases the yield of video capsule endoscopy.  Gastrointest Endosc. 2010;  71 AB364
  • 3 Lorenceau-Savale C, Landman C, Edery J. et al . Diagnostic yield and predictive factors of wireless capsule endoscopy (WCE) in premenopausal and postmenopausal women with obscure gastrointestinal bleeding (OGIB).  Gastrointest Endosc. 2010;  71 AB374
  • 4 Lai L H, Wong R M, Tsoi K K. et al . Negative capsule endoscopy (CE) predicts low rebleeding rate and mortality in obscure gastrointestinal bleeding (OGIB): results from long-term follow-up.  Gastroenterology. 2010;  138 S668
  • 5 Partridge B J, Heller S J, Tokar J L. et al . The diagnostic yield of device-assisted enteroscopy for acute middle gastrointestinal bleeding.  Gastrointest Endosc. 2010;  71 AB372
  • 6 Shishido T, Oka S, Tanaka S. et al . Clinical outcome of patients who have undergone total enteroscopy for obscure gastrointestinal bleeding.  Gastrointest Endosc. 2010;  71 AB353
  • 7 Gerson L B, Newsom S, Semrad C. et al . Risk factors for recurrent bleeding and/or anemia post-double balloon enteroscopy.  Gastroenterology. 2010;  138 S362
  • 8 Gerson L B, Newsom S, Semrad C E. Costs associated with outcomes post-double balloon enteroscopy.  Gastrointest Endosc. 2010;  71 AB365
  • 9 Aggarwal V, Day A S, Connor S J. et al . Capsule endoscopy findings in small bowel Crohn’s disease patients in clinical remission: correlation with the Crohn’s disease activity index, faecal calprotectin and S100a12.  Gastroenterology. 2010;  138 S114
  • 10 Yamagami H, Hosomi S, Takatsuka M. et al . Clinical utility of double-balloon endoscopy in the treatment of small-bowel strictures in inflammatory bowel disease.  Gastrointest Endosc. 2010;  71 AB375
  • 11 Pasha S F, Fujii L L, Sharma V K. et al . Incidence, management and outcomes of small bowel (SB) neoplasms in a cohort of 2000 patients undergoing video capsule endoscopy (CE): a single center experience.  Gastrointest Endosc. 2010;  71 AB373
  • 12 Pioche M, Filoche B, Jacob P. et al . Randomized prospective comparison of the diagnostic yield of PillCam SB2 and Mirocam videocapsules in patients with obscure digestive bleeding.  Gastrointest Endosc. 2010;  71 AB123
  • 13 Morita E, Ohtsuka N, Murano M. et al . A new slenderized self-propelling capsule endoscope enabled observation of porcine’s intestine.  Gastrointest Endosc. 2010;  71 AB143
  • 14 Swain P, Mosse C A, Volke F. et al . In vivo studies of the potential and limitations of remote control of functional wireless capsule endoscopes with rare earth magnetic inclusions in an extra-corporeal magnetic field.  Gastrointest Endosc. 2010;  71 AB123
  • 15 Fernandez-Urien I, Borobio E, Elizalde I. et al . Erythomycin administration in hospitalized patients undergoing capsule endoscopy: a prospective and randomized controlled trial.  Gastrointest Endosc. 2010;  71 AB123
  • 16 Efthymiou M, Desmond P, Taylor A C. Single balloon enteroscopy versus double balloon enteroscopy, preliminary results of a randomized controlled trial.  Gastrointest Endosc. 2010;  71 AB122
  • 17 Gallegos-Orozco J F, Yadav A, Ruff K C. et al . Predictors of successful retrograde double balloon enteroscopy (DBE).  Gastrointest Endosc. 2010;  71 AB375
  • 18 Basseri R J, Bucobo J C, Boulay B R. et al . Incidence and imaging characteristics of post-double balloon enteroscopy pancreatitis (post-DBEp).  Gastrointest Endosc. 2010;  71 AB369
  • 19 Aktas H, Mensink P, Biermann K. et al . Additional yield of histological sampling in patients with suspected small bowel pathology during balloon assisted enteroscopy.  Gastrointest Endosc. 2010;  71 AB378
  • 20 Shah R J, Smolkin M, Ross A S. et al . A multi-center, US experience of single balloon, double balloon, and rotational overtube enteroscopy-assisted ERCP in long limb surgical bypass patients.  Gastrointest Endosc. 2010;  71 AB134

Additional References: Bleeding and anemia

  • 21 Abdelaal U M, Morita E, Nouda S. et al . New scoring system for mucosal lesions of portal hypertensive enteropathy detected by capsule endoscopy: prospective study.  Gastrointest Endosc. 2010;  71 AB367
  • 22 Clark M E, Binmoeller K F, Allen M. et al . The utility of inpatient small bowel capsule endoscopy studies in patients hospitalized with obscure-overt gastrointestinal bleeding.  Gastroenterology. 2010;  138 S667
  • 23 Dunbar K B, Lennon A M, Okolo P I. et al . Spiral enteroscopy vs. small bowel enteroscopy for the evaluation of obscure GI bleeding.  Gastrointest Endosc. 2010;  71 AB370
  • 24 Efthymiou M, Taylor A C, Chen R. et al . The predictive value of FOBT before capsule endoscopy for obscure gastrointestinal bleeding.  Gastrointest Endosc. 2010;  71 AB379
  • 25 Fedorov E, Ivanova E V, Yudin O I. et al . The benefits of balloon-assisted enteroscopy in patients with intestinal bleeding: from precise diagnosis to reasonable treatment.  Gastrointest Endosc. 2010;  71 AB374
  • 26 Jeon S R, Kim J O, Kim H G. et al . The incidence and characteristics of obscure gastrointestinal bleeding lesions within reach of conventional endoscope.  Gastrointest Endosc. 2010;  71 AB356
  • 27 Johnson H P, Gilliam J H, Conway J. et al . Comparative sensitivity of magnetic resonance enterography versus capsule endoscopy and double balloon enteroscopy in evaluating obscure gastrointestinal bleeding.  Gastrointest Endosc. 2010;  71 AB355
  • 28 Maeda M, Kanke K, Sasai T. et al . Association of Helicobacter Pylori infection with enteritis in patients with obscure gastrointestinal bleeding using capsule endoscopy.  Gastrointest Endosc. 2010;  71 AB378
  • 29 Matsumura T, Arai M, Suzuki T. et al . Negative capsule endoscopy on management of the patients with obscure gastrointestinal bleeding is strongly related to anti-platelet agents therapy.  Gastroenterology. 2010;  138 S362
  • 30 Parikh D A, Mittal M, Mann S K. et al . Utilization and efficacy of video capsule endoscopy in the evaluation of anemia: influence of the severity of anemia on diagnostic yield.  Gastroenterology. 2010;  138 S668
  • 31 Riccioni M E, Cianci R, Urgesi R. et al . Evaluation of angiodysplasias in patients in oral anticoagulant therapy by capsule endoscopy.  Gastrointest Endosc. 2010;  71 AB320
  • 32 Riccioni M E, Urgesi R, Spada C. et al . Is negative capsule endoscopy in patients with obscure gastrointestinal bleeding reliable? Long-term follow-up and outcome in single centre large series.  Gastrointest Endosc. 2010;  71 AB207
  • 33 Ridtitid W, Treeprasertsuk S, Kongkam P. et al . Urgent double balloon enteroscopy in patients with overt obscure gastrointestinal bleeding.  Gastrointest Endosc. 2010;  71 AB365
  • 34 Yamada A, Watabe H, Isomura Y. et al . Urgent capsule endoscopy for the diagnosis of obscure-overt gastrointestinal bleeding.  Gastrointest Endosc. 2010;  71 AB366
  • 35 Yadav A, Ruff K C, Gallegos-Orozco J F. et al . Clinical outcomes after double balloon enteroscopy (DBE) for obscure GI bleeding (OGIB) in patients with documented follow-up.  Gastrointest Endosc. 2010;  71 AB251

Additional References: Inflammatory bowel diseases

  • 36 Girgis H Z, Dassopoulos T, Mullin G E. et al . Computer automated severity assessment of Crohn’s disease (CD) lesions in wireless capsule endoscopy (CE) images.  Gastroenterology. 2010;  138 S667
  • 37 Jensen M D, Nathan T, Kjeldsen J. Inter-observer agreement for detection of small bowel Crohn’s disease with capsule endoscopy.  Gastroenterology. 2010;  138 S524
  • 38 Moy L C, Greifer M K, Levine J J. Small intestinal transit time in children with Crohn’s disease.  Gastrointest Endosc. 2010;  71 AB257
  • 39 Moy L C, Levine J J. Delayed intestinal motility by capsule endoscopy as sign of Crohn’s disease.  Gastrointest Endosc. 2010;  71 AB256
  • 40 Petruzziello C, Onali S, Calabrese E. et al . Diagnostic role of capsule endoscopy in patients with symptoms highly compatible with Crohn’s disease.  Gastroenterology. 2010;  138 S525
  • 41 Safatle-Ribeiro A V, Vidolin E, Oliveira L B. et al . Double balloon endoscopy enhances the management of pediatric patients with Crohn’s disease.  Gastrointest Endosc. 2010;  71 AB376
  • 42 Watanabe K, Sogawa M, Hosomi S. et al . Clinical impact of retrograde deep insertion of single balloon endoscopy for patients with Crohn’s disease at times of conventional colonoscopy on outpatients.  Gastrointest Endosc. 2010;  71 AB204
  • 43 Watanabe O, Ando T, Ishiguro K. et al . Recurrence of ulcers after small bowel resection in patients with Crohn’s disease: efficacy of infliximab as assessed by double-balloon endoscopy.  Gastrointest Endosc. 2010;  71 AB376
  • 44 Watanabe O, Ando T, Ishiguro K. et al . Symptoms in patients with Crohn’s disease are related to the presence of strictures rather than to that of active ulcers in the small bowel by the examination of double-balloon enteroscopy.  Gastrointest Endosc. 2010;  71 AB375

Additional References: Tumors

  • 45 Gonçalves A R, Macedo T C, Velosa J. Small bowel tumors. A not so rare diagnosis.  Gastroenterology. 2010;  138 S661
  • 46 Ohmiya N, Nakamura M, Takenaka H. et al . Management of small bowel polyps in Peutz-Jeghers syndrome by using fluoroscopic enteroclysis, double-balloon endoscopy, and videocapsule endoscopy.  Gastrointest Endosc. 2010;  71 AB373
  • 47 Partridge B J, Heller S J, Tokar J L. et al . Small bowel cancers diagnosed at a referral center for device-assisted enteroscopy: a five year experience.  Gastrointest Endosc. 2010;  71 AB372
  • 48 Riccioni M E, Urgesi R, Spada C. et al . Increased diagnostic yield of small bowel tumors with Pillcam: the role of capsule endoscopy in diagnosis and treatment of gastrointestinal stromal tumours (GIST). Italian single-centre experience.  Gastroenterology. 2010;  138 S670
  • 49 Zagorowicz E, Wronska E, Pietrzak A. et al . Small bowel neoplasms detected and missed by capsule. A single centre experience.  Gastrointest Endosc. 2010;  71 AB376

Additional References: Innovations, new capsules

Additional References: Technical aspects of small-bowel endoscopy

Additional References: Miscellaneous topics

M. PennazioMD 

Division of Gastroenterology 2
Department of Medicine
S. Giovanni AS University Teaching Hospital

Via Cavour 31
10123 Turin
Italy

Fax: +39-011-6333623

Email: pennazio.marco@gmail.com