A retrospective study of the application on double-balloon enteroscopy in 378 patients with suspected small-bowel diseases

Background and study aims: The diagnostic yield of double-balloon enteroscopy (DBE) is variable, depending on the indication for the investigaton. The aim of this study was to investigate the diagnostic yield of DBE, and impact on subsequent management. Patients and methods: A total of 378 patients with obscure gastrointestinal bleeding, abdominal pain, diarrhea, or small-bowel obstruction were included in this retrospective study. DBE procedures were followed by active treatments, symptomatic treatments, or follow-up without any treatment. A special scoring system was designed for evaluating the severity of gastrointestinal bleeding, and the scores were compared before and after DBE examination. Results: Lesions were detected in 247/378 patients (65.3 %). The diagnostic yields were 80.6 % for obscure gastrointestinal bleeding, 37.7 % for abdominal pain, 36.5 % for diarrhea, and 81.3 % for small-bowel obstruction. In 208/247 patients with a confirmed diagnosis (84.2 %), specific treatments were performed. Symptoms disappeared or improved in 190/208 patients (91.3 %). The mean score (± standard deviation) for the severity of gastrointestinal bleeding in the 154 patients with positive findings before DBE was 6.8 ± 2.2, and this dropped to 1.5 ± 0.5 (P < 0.01) in patients who underwent specific treatments, to 3.6 ± 0.7 (P < 0.05) in patients who received symptomatic relief, and to 3.9 ± 0.9 (P < 0.05) in patients who received no treatment. Conclusions: Double-balloon enteroscopy had high diagnostic yield in patients with obscure gastrointestinal bleeding and obstruction. The results of DBE had a substantial impact on subsequent management decisions.

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