ENTEROSCOPY-ENTEROCLYSIS - EXPERIENCE WITH A COMBINED ENDOSCOPIC-RADIOGRAPHIC TECHNIQUE

Background: Video enteroscopy provides high-quality diagnostic and the rapeutic capabilities in the proximal small bower. Enteroclysis remain s an essential diagnostic technique in the distal small bower. We repo rt our experience with the combination of these techniques. Methods: S eventy-one patients with obscure gastrointestinal bleeding (group A, 5 4 patients) or abnormal radiologic studies (group B, 17 patients) were evaluated with enteroscopy. Enteroclysis via a tube inserted on withd rawal of the enteroscope was performed in all patients with nondiagnos tic enteroscopy. Results: Enteroscopy identified bleeding sites in 29 of 54 (54%) group A patients (12 angiodysplasia, 10 ulcers, 7 gastric erosions, 1 vessel, 1 aortoenteric fistula), and lesions in 11 of 17 ( 65%) group B patients (7 ulcers, 3 benign strictures, 2 radiation ente ritis, 1 mass). In group A, 13 (24%) patients had findings detectable by standard esophagogastroduodenoscopy. Enteroclysis identified masses in 2 of 24 (8%) group A patients, and lesions in 5 of 10 (50%) group B patients (3 strictures, 1 mass, 1 large diverticulum). No complicati ons occurred. Conclusions: The combination of enteroscopy and enterocl ysis is safe and offers quality small bower examinations in more comfo rtable and convenient single diagnostic sittings. This combination det ected bleeding sources in 57% and lesions in 70% of patients. Though e nteroclysis identified breeding sources in only 8% of patients, this s tudy excluded lesions other than angiodysplasia.