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aklap
Joined: 02 Oct 2004
Posts: 8794
Location: WI, USA
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 Posted: Fri Aug 25, 2006 1:41 pm Post subject: Double-balloon Enteroscopy |
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Clinically significant small-bowel pathology identified by double-balloon enteroscopy but missed by capsule endoscopy.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16923502&query_hl=1&itool=pubmed_docsum
| Quote: | 1: Gastrointest Endosc. 2006 Sep;64(3):445-9. Links
Chong AK,
Chin BW,
Meredith CG.
Current affiliations: Department of Gastroenterology, Bankstown Hospital (Drs Chong, Chin, and Meredith), Bankstown, Department of Medicine, University of New South Wales (Dr Chong) Sydney, New South Wales, Australia.
BACKGROUND: Capsule endoscopy (CE) is increasingly being used to investigate the small bowel for various indications, including obscure GI bleeding (OGB). However, false negatives have been described. Double-balloon enteroscopy (DBE) is a new endoscopic technique developed to potentially view the entire small intestine while allowing therapeutic options to be carried out when appropriate. OBJECTIVE: We described 4 patients with small-bowel pathology missed on CE but detected by DBE. DESIGN: Descriptive retrospective study. All patients underwent CE followed by DBE. SETTING: Single-center tertiary referral hospital. PATIENTS: Four patients were included. Three patients had OGB that required blood transfusions. One patient with celiac disease, compliant on a strict gluten-free diet for 5 months, presented with persistent weight loss and abdominal pain. INTERVENTIONS: DBE followed by surgical exploration and resection of small-bowel pathology. MAIN OUTCOME MEASUREMENTS: Successful identification of pathology missed by CE. Definitive treatment of small-bowel pathology by surgical resection. RESULTS: CE did not identify the small-bowel pathology in all 4 patients. The 3 patients with OGB had small-bowel masses found by DBE. Two of these were GI stromal tumors and one was an adenocarcinoma. The patient with celiac disease had a malignant ulcer, confirmed to be a lymphoma after surgical resection. LIMITATIONS: Retrospective study and small sample size. CONCLUSIONS: CE and DBE are complementary investigations. If there is a high index of suspicion of small-bowel pathology despite a negative CE, DBE should be performed.
PMID: 16923502 [PubMed - in process] |
Interesting new test...
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Al
“We cannot all do great things, but we can do small things with great love.” Mother Teresa |
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gluten-free-mike
Joined: 07 Sep 2006
Posts: 349
Location: Cleveland, OH
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| Posted: Wed Sep 13, 2006 3:07 pm Post subject: |
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Interesting indeed.
It always makes me wonder after having any test, and then reading about a "new and improved" test, whether the original was valid and/or missed something important. There is also a significant delay between such new tests and techniques proving out in studies and actually making into commonplace use in the medical setting. Some is due to cost, like moving from a 16-slice CT-Scan unit to a 64-slice (may require $2-3MM dollar outlay per unit), and there is always the issue of Physician education and training on any new and preferred methods. We won't even get into the insurance-coverage issue that considers quite a few things "experimental" for a long period of time so as not to cover them.
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Mike
GF Since 2003
Severe weakness for Desserts |
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