Published online Aug 7, 2013. doi: 10.3748/wjg.v19.i29.4726
Revised: April 18, 2013
Accepted: May 9, 2013
Published online: August 7, 2013
AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients.
METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey between 2009 and 2011 were examined retrospectively. Adult and pediatric patients were compared according to DBE indications, procedure duration, final diagnosis, and complications. DBE procedures were performed in an operating room under general anesthesia by two endoscopists. An oral or anal approach was preferred according to estimated lesion sites. Overnight fasting of at least 6 h prior to the start of the procedure was adequate for preprocedural preparation of oral DBE procedures. Bowel cleansing was performed by oral administration of sennosides A and B solution, 2 mL/kg, and anal saline laxative enema. The patients were followed up for 2 h after the procedure in terms of possible complications.
RESULTS: DBE was performed in 35 patients (5 pediatric and 30 adult). DBE procedures were performed for abdominal pain, chronic diarrhea, bleeding, chronic vomiting, anemia, and postoperative evaluation of anastomosis. Final diagnosis was diffuse gastric angiodysplasia (n = 1); diffuse jejunal angiodysplasia (n = 1); ulceration in the bulbus (n = 1); celiac disease (n = 1); low differentiated metastatic carcinoma (n = 1); Peutz-Jeghers syndrome (n = 1); adenomatous polyp (n = 1) and stricture formation in anastomosis line (n = 1). During postprocedural follow-up, abdominal pain and elevated amylase levels were noted in three patients and one patient developed abdominal perforation.
CONCLUSION: With the help of technological improvements, we may use enteroscopy as a safe modality more frequently in younger and smaller children.
Core tip: Small bowel diseases are encountered frequently in adults and children. For diagnosing small bowel disease, endoscopy, barium series, ultrasound, and computed tomography methods were used before advanced techniques such as capsule endoscopy and double balloon enteroscopy (DBE). Many centers began to use DBE widely in adults and children. Interventional procedures of DBE in children are also as safe as in adult patients. Although a small number of children were included in the present study, this is believed to be the first comparison of DBE in adult and pediatric patients.