Diagnostic and Therapeutic Role of Single Balloon Enteroscopy (SBE) in Small Bowel Disease

Authors: Kanni PY, Mathew P*, Gowda M, Uppalapati S, Garg A and Ansari J

DOI: 10.23880/ghij-16000163

Volume 4, Issue 2

Abstract

Introduction: The small Intestine has long been considered a Pandora’s Box by gastroenterologists because of its long length and the presence of multiple complex loops. With developments of device assisted enteroscopy there is significant improvement in the assessment and diagnostic yield of small bowel diseases. Aim: To assess the diagnostic and therapeutic role of single balloon enteroscopy (SBE) in patients with small bowel disease. Materials and methods: A retrospective, single-centre study, where we analyzed records of patients over 5 year duration between March 2014 & February 2019. Consecutive patients who fulfilled the necessary criteria were included in the study. SBE system used was SIF-Q180 enteroscope, an overtube balloon control unit (OBCU Olympus Balloon Control Unit). Results: Total patients evaluated were 114, Male – 73 (64%), Female – 41(36%), Enteroscopy was performed in 61(53.50%) patients with suspected small intestinal inflammatory bowel disease (IBD)/Intestinal tuberculosis, and in 43(37.72%) with obscure gastro-intestinal (G.I) bleed. Approach was by per oral route in 33(28.94%), per rectal route in 59(51.76%), and both oral and rectal route in 22(19.30%). Enteroscopy findings: Ulcers and erosions in small intestine 58(50.88%), strictures in 28(24.56%), nodularity in 15(13.15%), Angioectasia in 7(6.1%), polyps in 6(5.2%), polypoidal lesions in 6(5.2%), Dieulafoy lesion in 2(1.8%) and normal enteroscopy findings in 15(13.15%) patients. Interventions were performed in 22 patients- SBE assisted through the scope (TTS) dilatation was done in 10 patients, SBE assisted hemostasis was achieved in 9 patients and SBE assisted ERCP was done in 3 patients. The commonest histopathological diagnosis was Crohn’s disease 39(34.21%), followed by Tuberculosis in 6(5.26%), adenomatous polyp in 3(2.6%), intestinal lymphoma in 3 (2.6%), non specific changes in 28(24.56%), GIST in 4(3.5%) patients. Conclusion: SBE demonstrated a high diagnostic yield and provided an effective mode of therapeutic intervention in carefully selected patients. Therapeutic interventions with good success rate can be achieved with SBE avoiding the need for surgical interventions.

Keywords: IBD-Inflammatory Bowel Disease; Obscure G.I (Gastro-Intestinal) Bleed; Stricturoplasty; SBE-Small Bowel Disease

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