Diagnostic value of double balloon enteroscopy for small-intestinal disease: experience from China.

Background: Diseases of the small intestine include, among others, ulceration, chronic inflammation, Meckel's diverticula, vascular deformities, and cancer.

Objective: To study the diagnostic value of double balloon enteroscopy (DBE) for small-intestinal disease in a Chinese patient cohort.

Design: DBE was performed via the mouth, anus, or both approaches to diagnose small-intestinal disease.

Patients: We studied 155 patients with clinically suspected small-intestinal disease: 110 men and 45 women. Their age ranged from 6 to 75 (mean 41). There were 92 cases with small-intestinal hemorrhage, 39 with abdominal pain, 7 with diarrhea, 13 with abdominal distention, 3 cases with malnutrition, and 1 with diarrhea and refractory hypoalbuminemia.

Results: Among the 155 patients, lesions were found in 126 (81.3%). These lesions found were small-intestinal ulcers (including Crohn's disease), chronic inflammation, Meckel's diverticulae, vascular deformities, and carcinoma. Eighty-five of the 92 patients with suspected intestinal hemorrhage were confirmed, with a positive rate of 92.4%. Also confirmed were 24 of the 39 patients with abdominal pain (positive rate of 61.5%); 16 of the 23 patients with diarrhea, abdominal distention, or malnutrition (positive rate of 69.6%); and 1 patient with refractory hypoalbuminemia. Among the 126 patients with positive findings, the lesions were located in the small intestine in 116 patients, in the stomach and duodenum in 9 patients, and in the colon in 1 patient. In the 45 patients with small-intestinal ulcer, 29 patients had recurrent hemorrhage, 9 had abdominal pain, 4 had abdominal distention, 2 had malnutrition, and 1 had diarrhea. Ulcers were located in the jejunum in 20 patients, in the ileum in 20 patients, and in both the jejunum and ileum in 5 patients. For 7 patients with small-intestinal ulceration diagnosed as Crohn's disease, the concordance rate of diagnosis between preoperative and postoperative diagnosis was 57.1%, lower than other diseases (P < .01). One patient had a perforation.

Conclusion: DBE is effective and safe for the diagnosis of small-intestine disease in a Chinese patient cohort.