| Theme | Update of Endoscopy for Small Intestine | |
|---|---|---|
| Title | Video Capsule Endoscopy and Double Balloon Endoscopy | |
| Publish Date | 2007/03 | |
| Author | Tsuyoshi Kobayashi | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| Author | Shu Tanaka | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| Author | Yukie Yamada | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| Author | Akihito Ehara | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| Author | Keigo Mitsui | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| Author | Tsuguhiko Seo | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| Author | Shunji Fujimori | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| Author | Choitsu Sakamoto | The Department of Internal Medicine, the Division of Gastroenterology, Nippon Medical School |
| [ Summary ] | Video capsule endoscopy (VCE) and double balloon endoscopy (DBE) have had a dramatic impact on the diagnosis and treatment of small intestinal diseases. In this section, we evaluate the indications, contraindications, complications, and necessary preparation or sedation pertaining to each modality. The presence of occult bleeding is currently the most reliable indicator for the use of either type of examination. However, only DBE is indicated in patients with small bowel strictures and fistulae for fear of entrapment of the VCE in such cases, due to intestinal stenosis. In particular, DBE enables tissue sampling, dilatation of small bowel stenosis and removal of foreign bodies while allowing for therapeutic intervention in patients with small intestinal hemorrhages. Therefore, in patients with suspected alimentary tract stenosis, VCE should only be undertaken in centers with fully equipped endoscopic facilities, that would allow for intervention should the capsule endoscope become entrapped. As for complications involving DBE, a few cases of acute pancreatitis have been reported in addition to traditional enteroscopic complications. Careful insertion of the enteroscope should eliminate such complications. There is an accumulating body of evidence evaluating VCE and DBE in the treatment of small bowel diseases, and guidelines for both examinations are beginning to emerge. |
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