Endoskopie des Dünndarms

Zusammenfassung

Nach Einführung der flexiblen Endoskopie für den oberen und unteren Intestinaltrakt in den 1950er Jahren und der Erschließung des bilio-pankreatischen Systems für die Endoskopie in den 1970ern ist im neuen Jahrhundert nun auch der Dünndarm mit endoskopischen Methoden in der klinischen Routinediagnostik und -therapie zugänglich. Die Kapselendoskopie steht mit hoher Genauigkeit als nicht-invasive Technik für die Abklärung verschiedener Krankheitsbilder zur Verfügung, wie mittlere intestinale Blutung, Morbus Crohn des Dünndarms und eine Reihe von weiteren Dünndarmerkrankungen wie die Überwachung beim Peutz-Jeghers-Syndrom. Die Doppelballonenteroskopie ergänzt diese Methode bei gezielter Fragestellung zur weiteren histologischen Abklärung oder nicht-chirurgischen Therapie. Das endoskopische Repertoire der Diagnostik und Therapie von Dünndarmerkrankungen wird in dieser Übersichtsarbeit dargestellt.

Summary

Routine endoscopy of the small bowel has found its way into clinical practice within the last few years. Capsule endoscopy (CE) enables with high accuracy detection of the source of mid intestinal bleeding. Crohn’s disease of the small bowel is sensitively detected and surveillance in polyposis syndroms is improved by applying sensitive, non-invasive endoscopic means. Double-balloon enteroscopy (DBE) may be used complementary to CE by offering therapeutic possibilities and providing histopathological specimen. This review describes the diagnostic and therapeutic repertoire that is offered by modern small bowel endoscopy.

Endoskopie - Kapselendoskopie - Doppelballonenteroskopie - Doppelballonendoskopie - Enteroskopie

capsule endoscopy - small bowel enteroscopy - push-and-pull enteroscopy - small bowel endoscopy

Literatur

• 1 Adler S N, Bjarnason I, Metzger Y C. New balloon guided technique for deep small-intestine endoscopy using standard endoscopes.  Endoscopy.. Epub ahead of print. DOI 10.1055/s-2007-995677
• 2 Akerman P, Cantero D. et al. . Novel method of enteroscopy using EndoEase Discovery SB overtube.  Gastrointest Endosc. 2007;  65 AB125
• 3 Albert J, Gobel C. et al. . Simethicone for small bowel preparation for capsule endoscopy.  Gastrointest Endosc. 2004;  59 487-91
• 4 Albert J G, Martiny F, Krummenerl A. et al . Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis.  Gut. 2005;  54 1721-1727
• 5 Albert J G, Schülbe R. et al . Impact of capsule endoscopy on outcome in mid intestinal bleeding.  Europ Gastroenterol Hepatol. 2008;  20, in press
• 5b Albert J G, Fiedler E. et al . Consequence of detecting small bowel metastasis of malignant melanoma by capsule endoscopy.  Am J Gastroenterol. 2008;  103 244-245
• 6 Apostolopoulos P, Liatsos C, Gralnek I M. et al . The role of wireless capsule endoscopy in investigating unexplained iron deficiency anemia after negative endoscopic evaluation of the upper and lower gastrointestinal tract.  Endoscopy. 2006;  38 1127-32
• 7 Bandorski D, Irnich W, Bruck M, Beyer N, Kramer W, Jakobs R. Capsule endoscopy and cardiac pacemakers.  Endoscopy. 2008;  40 36-39
• 8 Benz C, Martin W R, Arnold J, Jakobs R, Riemann J F. Die endoskopische Untersuchung des Dunndarms mit Push-Enteroskopie. Eine prospektive Untersuchung.  Dtsch Med Wochenschr. 1997;  122 391-5
• 9 Bourreille A, Jarry M, D’Halluin P N. et al . Wireless capsule endoscopy versus ileocolonoscopy for the diagnosis of postoperative recurrence of Crohn’s disease: a prospective study.  Gut. 2006;  55 978-83
• 10 Caddy G R, Moran L. et al. . The effect of erythromycin on video capsule endoscopy intestinal-transit time.  Gastrointest Endosc. 2006;  63 262-266
• 11 Cheifetz A S, Kornbluth A A, Legnani P. et al . The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease.  Am J Gastroenterol. 2006;  101 2218-22
• 12 Chong A KH, Taylor A, Miller A, Hennessy O, Connell W, Desmond P. Capsule endoscopy vs. push enteroscopy and enteroclysis in suspected small-bowel Crohn’s disease.  Gastrointest Endosc. 2005;  61 255-61
• 13 Cobrin G M, Pittman R H, Lewis B S. Increased diagnostic yield of small bowel tumors with capsule endoscopy.  Cancer. 2006;  107 22-7
• 14 Daum S, Wahnschaffe U, Glasenapp R. et al . Capsule endoscopy in refractory celiac disease.  Endoscopy. 2007;  39 455-8
• 15 Faigel D O. et al . ASGE guideline: guidelines for credentialing and granting privileges for capsule endoscopy.  Gastrointest Endosc. 2005;  61 503-5
• 16 Fidder H H, Nadler M, Lahat A. et al . The utility of capsule endoscopy in the diagnosis of Crohn’s disease based on patient’s symptoms.  J Clin Gastroenterol. 2007;  41 384-7
• 17 Flieger D, Keller R, May A, Ell C, Fischbach W. Capsule endoscopy in gastrointestinal lymphomas.  Endoscopy. 2005;  37 1174-80
• 18 Fujimori S, Seo T, Gudis K. et al . Diagnosis and treatment of obscure gastrointestinal bleeding using combined capsule endoscopy and double balloon endoscopy: 1-year follow-up study.  Endoscopy. 2007;  39 1053-1058
• 19 Gay G, Delvaux M, Fassler I. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy.  Endoscopy. 2006;  38 49-58
• 20 Ginsberg G G, Barkun A N, Bosco J J. et al . Wireless capsule endoscopy: August 2002.  Gastrointest Endosc. 2002;  56 621-4
• 21 Graham D Y. et al. . Visible small-intestinal mucosal injury in chronic NSAID users.  Clin Gastroenterol Hepatol. 2005;  3 55-9
• 22 Hadithi M, Heine G DN. et al . A prospective study comparing video capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding.  Am J Gastroenterol. 2006;  101 52-7
• 23 Hartmann D, Schmidt H, Bolz G. et al . A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding.  Gastrointest Endosc. 2005;  61 826-32
• 24 Hawkey C J, Ell C, Simon B. et al . Less small-bowel injury with lumiracoxib compared with naproxen plus omeprazole.  Clin Gastroenterol Hepatol. 2008; epub ahead of print; 
• 25 Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy.  Nature. 2000;  405 417
• 26 Jakobs R, Hartmann D, Benz C. et al . Diagnosis of obscure gastrointestinal bleeding by intra-operative enteroscopy in 81 consecutive patients.  World J Gastroenterol. 2006;  12 313-6
• 27 Johanssen S, Boivin M, Lochs H. et al . The yield of wireless capsule endoscopy in the detection of neuroendocrine tumors in comparison with CT enteroclysis.  Gastrointest Endosc. 2006;  63 660-5
• 28 Junquera F, Feu F, Papo M. et al . A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia.  Gastroenterology. 2001;  121 1073-9
• 29 Kaffes A J, Siah C, Koo J H. Clinical outcomes after double-balloon enteroscopy in patients with obscure GI bleeding and a positive capsule endoscopy.  Gastrointest Endosc. 2007;  66 304-9
• 30 Kopacova M, Rejchrt S, Tacheci I, Bures J. Hyperamylasemia of uncertain significance associated with oral double-balloon enteroscopy.  Gastrointest Endosc. 2007;  66 1133-8
• 31 Kwan V, Bourke M J, Williams S J. et al . Argon plasma coagulation in the management of symptomatic gastrointestinal vascular lesions.  Am J Gastroenterol. 2006;  101 58-63
• 32 May A, Manner H, Schneider M. et al. . Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study).  Endoscopy. 2007;  39 606-12
• 33 May A, Nachbar L. et al. . Endoscopic interventions in the small bowel using double balloon enteroscopy.  Am J Gastroenterol. 2007;  102 527-35
• 34 Mensink P BF, Haringsma J, Kucharzik T. et al . Complications of double balloon enteroscopy: a multicenter survey.  Endoscopy. 2007;  39 613-5
• 35 Mergener K, Ponchon T, Gralnek I. et al . Literature review and recommendations for clinical application of small-bowel capsule endoscopy, based on a panel discussion by international experts. Consensus statements for small-bowel capsule endoscopy, 2006/2007.  Endoscopy. 2007;  39 895-909
• 36 Mishkin D S, Chuttani R, Croffie J. et al . ASGE Technology Status Evaluation Report: wireless capsule endoscopy.  Gastrointest Endosc. 2006;  63 539-45
• 37 Nakamura M, Niwa Y, Ohmiya N. et al . Preliminary comparison of capsule endoscopy and double-balloon enteroscopy in patients with suspected small-bowel bleeding.  Endoscopy. 2006;  38 59-66
• 38 Neu B, Ell C, May A. et al . Capsule endoscopy versus standard tests in influencing management of obscure digestive bleeding: results from a German multicenter trial.  Am J Gastroenterol. 2005;  100 1736-1742
• 39 Rondonotti E, Spada C, Cave D. et al . Video Capsule Enteroscopy in the diagnosis of celiac disease.  Am J Gastroenterol. 2007;  102 1624-1631
• 40 Rösch T, Ell C. Derzeitige Bewertung der Kapselendoskopie in der Diagnostik von Dunndarmerkrankungen - Update des Positionspapiers der Sektion Endoskopie der DGVS, Stand 1/2004.  Z Gastroenterol. 2004;  42 247-59
• 41 Rösch T, Ell C. Derzeitige klinische Indikationen der Kapsel-Endoskopie - Positionspapier der Sektion Endoskopie der DGVS, Stand 1.11.2002.  Z Gastroenterol. 2002;  40 971-8
• 42 Schulmann K, Hollerbach S, Kraus K. et al . Feasibility and diagnostic utility of video capsule endoscopy for the detection of small bowel polyps in patients with hereditary polyposis syndromes.  Am J Gastroenterol. 2005;  100 27-37
• 43 Selby W. Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide.  Gastrointest Endosc. 2005;  61 80-5
• 44 Shim K, Kim Y, Kim K. et al . Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy: a Korean multicenter study.  Scand J Gastroenterol. 2006;  41 983-8
• 45 Sidhu R, Sanders D S, Morris A J, McAlindon M E. Guidelines on small bowel enteroscopy and capsule endoscopy in adults.  Gut. 2008;  57 125-36
• 46 Spigelman A D, Williams C B. et al . Upper gastrointestinal cancer in patients with familial adenomatous polyposis.  Lancet. 1989;  2 783-5
• 47 Sugano K, Marcon N. The First International Workshop on Double Balloon Endoscopy.  Gastrointest Endosc. 2007;  66 S7-11
• 48 Sunada K, Yamamoto H, Kita H. et al . Clinical outcomes of enteroscopy using the double-balloon method for strictures of the small intestine.  World J Gastroenterol. 2005;  11 1087-9
• 49 Triester S L, Leighton J A. et al . A Meta-Analysis of the yield of Capsule Endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding.  Am J Gastroenterol. 2005;  100 2407-2418
• 50 Triester S L. et al . A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease.  Am J Gastroenterol. 2006;  101 954-64
• 51 Tsujikawa T, Saitoh Y. et al . Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine.  Endoscopy. 2007; epub; 
• 52 Voderholzer W A, Beinhoelzl J, Rogalla P. et al . Small bowel involvement in Crohn’s disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis.  Gut. 2005;  54 369-73
• 53 Yamamoto H, Sekine Y, Sato Y. et al . Total enteroscopy with a nonsurgical steerable double-balloon method.  Gastrointest Endosc. 2001;  53 216-20
• 54 de Leusse A, Vahedi K, Edery J. et al . Capsule endoscopy or push enteroscopy for first-line exploration of obscure gastrointestinal bleeding?.  Gastroenterology. 2007;  132 855-62; quiz 1164 - 5
• 55 van Tuyl S AC, den Ouden H, Stolk M FJ, Kuipers E J. Optimal preparation for video capsule endoscopy.  Endoscopy. 2007;  39 1037-1040