DIAGNOSTIC YIELD OF PUSH-TYPE ENTEROSCOPY IN RELATION TO INDICATION

Background-Push-type enteroscopy, a recent method for investigating th e small intestine, is currently undergoing assessment. Its diagnostic yield varies in the studies reported to date. Aim-To assess the diagno stic value of push-type enteroscopy according to indication. Patients and methods-From January 1994 to September 1995, 152 consecutive patie nts (mean age 34 years) underwent push-type enteroscopy (jejunoscopy, n=93; retrograde ileoscopy, n=17; and double way enteroscopy; n=42). T he indications were: unexplained iron deficiency anaemia or macroscopi c gastrointestinal bleeding (n=76), radiological abnormalities of the small intestine (n=23), chronic diarrhoea and/or malabsorption syndrom e (n=18), abdominal pain (n=12), and miscellaneous (n=23). All patient s had undergone previous negative aetiological investigations. Results -The jejunum and ileum were explored through 120 cm (30-160 cm) and 60 cm (20-120cm). Digestive bleeding: lesions of the small bowel were fo und in 6% of the patients with isolated iron deficiency anaemia and 20 % of patients with patent digestive haemorrhage. Radiological abnormal ities of the small intestine: push-type enteroscopy provided a diagnos is or modified the interpretation of radiological findings in 18/23 ca ses (78%). Chronic diarrhoea and/or malabsorption: push-type enterosco py yielded explanatory findings in four cases (22%). Abdominal pain: p ush-type enteroscopy provided no diagnosis. Conclusion-In this series, push-type enteroscopy was of particular value in investigating patien ts with radiological abnormalities of the small intestine. It was of s ome value in the exploration of patent digestive haemorrhage or chroni c diarrhoea, but not of abdominal pain. Its value was Limited in the e xploration of iron deficiency anaemia.