AIM: To assess the feasibility and utility of double balloon enteroscopy (DBE) in the management of small bowel diseases in children. METHODS: Fourteen patients (10 males) with a median age of 12.9 years (range 8.1-16.7) underwent DBE; 5 for Peutz-Jeghers syndrome (PJ syndrome), 2 for chronic abdominal pain, 4 for obscure gastrointestinal (GI) bleeding, 2 with angiomatous malformations (1 blue rubber bleb nevus syndrome) having persistent GI bleeding, and 1 with Cowden's syndrome with multiple polyps and previous intussusception. Eleven procedures were performed under general anesthesia and 3 with deep sedation. RESULTS: The entire small bowel was examined in 6 patients, and a length between 200 cm and 320 cm distal to pylorus in the remaining 8. Seven patients had both antegrade (trans-oral) and retrograde (trans-anal and via ileostomy) examinations. One patient underwent DBE with planned laparoscopic assistance. The remaining 6 had trans-oral examination only. The median examination time was 118 min (range 95-195). No complications were encountered. Polyps were detected and successfully removed in all 5 patients with PJ syndrome, in a patient with tubulo-villous adenoma of the duodenum, in a patient with significant anemia and occult bleeding, and in a patient with Cowden's syndrome. A diagnosis was made in a patient with multiple angiomata not amenable to endotherapy, and in 1 with a discrete angioma which was treated with argon plasma coagulation. The source of bleeding was identified in a further patient with varices. DBE was normal or revealed minor mucosal friability in the remaining 3 patients. Hence a diagnostic yield of 11/14 with therapeutic success in 9/14 was achieved. CONCLUSION: Double balloon enteroscopy can be a useful diagnostic and therapeutic tool for small bowel disease in children, allowing endo-therapeutic intervention beyond the reach of the conventional endoscope.
AIM: To assess the feasibility and utility of double balloon enteroscopy (DBE) in the management of small bowel diseases in children. METHODS: Fourteen patients (10 males) with a median age of 12.9 years (range 8.1-16.7) underwent DBE; 5 for Peutz-Jeghers syndrome (PJ syndrome), 2 for chronic abdominal pain, 4 for obscure gastrointestinal (GI) bleeding, 2 with angiomatous malformations (1 blue rubber bleb nevus syndrome) having persistent GI bleeding, and 1 with Cowden's syndrome with multiple polyps and previous intussusception. Eleven procedures were performed under general anesthesia and 3 with deep sedation. RESULTS: The entire small bowel was examined in 6 patients, and a length between 200 cm and 320 cm distal to pylorus in the remaining 8. Seven patients had both antegrade (trans-oral) and retrograde (trans-anal and via ileostomy) examinations. One patient underwent DBE with planned laparoscopic assistance. The remaining 6 had trans-oral examination only. The median examination time was 118 min (range 95-195). No complications were encountered. Polyps were detected and successfully removed in all 5 patients with PJ syndrome, in a patient with tubulo-villous adenoma of the duodenum, in a patient with significant anemia and occult bleeding, and in a patient with Cowden's syndrome. A diagnosis was made in a patient with multiple angiomata not amenable to endotherapy, and in 1 with a discrete angioma which was treated with argon plasma coagulation. The source of bleeding was identified in a further patient with varices. DBE was normal or revealed minor mucosal friability in the remaining 3 patients. Hence a diagnostic yield of 11/14 with therapeutic success in 9/14 was achieved. CONCLUSION: Double balloon enteroscopy can be a useful diagnostic and therapeutic tool for small bowel disease in children, allowing endo-therapeutic intervention beyond the reach of the conventional endoscope.
Authors: M Appleyard; Z Fireman; A Glukhovsky; H Jacob; R Shreiver; S Kadirkamanathan; A Lavy; S Lewkowicz; E Scapa; R Shofti; P Swain; A Zaretsky Journal: Gastroenterology Date: 2000-12 Impact factor: 22.682
Authors: H Yamamoto; Y Sekine; Y Sato; T Higashizawa; T Miyata; S Iino; K Ido; K Sugano Journal: Gastrointest Endosc Date: 2001-02 Impact factor: 9.427
Authors: Tanja Brunnler; Frank Klebl; Sascha Mundorff; Christoph Eilles; Michael Reng; Hans von Korn; Jurgen Scholmerich; Julia Langgartner; Stefan Grune Journal: World J Gastroenterol Date: 2008-08-28 Impact factor: 5.742
Authors: A Mata; J M Bordas; F Feu; A Ginés; M Pellisé; G Fernández-Esparrach; F Balaguer; J M Piqué; J Llach Journal: Aliment Pharmacol Ther Date: 2004-07-15 Impact factor: 8.171
Authors: Giovanni Di Nardo; Carlo Calabrese; Roberto Conti Nibali; Arianna De Matteis; Emanuele Casciani; Luigi Martemucci; Giuseppe Pagliaro; Nico Pagano Journal: United European Gastroenterol J Date: 2018-07-12 Impact factor: 4.623