Brief Article
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World J Gastroenterol. Aug 7, 2013; 19(29): 4726-4731
Published online Aug 7, 2013. doi: 10.3748/wjg.v19.i29.4726
Comparison of double balloon enteroscopy in adults and children
Odul Egritas Gurkan, Tarkan Karakan, Ibrahim Dogan, Buket Dalgic, Selahattin Unal
Odul Egritas Gurkan, Buket Dalgic, Department of Pediatric Gastroenterology, School of Medicine, Gazi University, 06500 Ankara, Turkey
Tarkan Karakan, Ibrahim Dogan, Selahattin Unal, Department of Gastroenterology, School of Medicine, Gazi University, 06500 Ankara, Turkey
Author contributions: Gurkan OE designed the study; Gurkan OE, Karakan T and Dogan I acquired, collected and elaborated the data; Gurkan OE and Karakan T wrote the article; Gurkan OE, Karakan T and Dogan I performed enteroscopies; Dalgic B and Unal S drafted the article and revised it critically for important intellectual content; Karakan T revised and approved the final version.
Correspondence to: Tarkan Karakan, MD, Associate Professor, Department of Gastroenterology, School of Medicine, Gazi University, TR-06510 Besevler, 06500 Ankara, Turkey.
Telephone: +90-312-2025819 Fax: +90-312-2236365
Received: January 12, 2013
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.

Keywords: Double-balloon enteroscopy, Small bowel disease, Polyp, Angiodysplasia, Peutz-Jeghers syndrome

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.