Jr. Willis et al., ENTEROSCOPY-ENTEROCLYSIS - EXPERIENCE WITH A COMBINED ENDOSCOPIC-RADIOGRAPHIC TECHNIQUE, Gastrointestinal endoscopy, 45(2), 1997, pp. 163-167
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.