A Clinical Study On The Diagnostic Value Of Double-balloon Enteroscopy And Abdominal Computed Tomography In Small Bowel Disease

Objective To evaluate the diagnostic value of duoble-balloon enteroscopy(DBE)and abdominal computed tomography(CT)in small bowel disease.Methods Ninety eight DBE procedures were carried out in 90 patients (50 men,40 women;mean age 47.5 years,range 16-83 years)with suspected small bowel disease.The diagnostic value of DBE was compared with that of CT.The indications for the examination were obscure gastrointestinal bleeding(n=40), incomplete small-bowel obstruction(n=24),chronic abdominal pain(n=20),chronic diarrhea(n=4),fever of unknown origin(n=1)and malnutrition(n=1).All underwent gastroscopy and colonoscopy,37 of them even received capsule endoscopy,but definite diagnosis was not made,then followed by DBE.CT was performed in 70 patients.Results DBE identified lesions in 51 patients(56.7%).Twenty kinds of small bowel lesions were detected,mainly including Crohn's disease,adenocarcinoma, gastrointestinal stroma tumor,vascular deformity,lymphoma,Meckel's diverticulum and polyp.The mean duration of the procedure was 110 min(range 30min - 300min). There were no complications and the procedures were tolerated well.Twenty patients received surgical intervention.Among patients who received CT,the diagnostic yield of DBE(57.1%)was significantly higher than that of CT(31.4%,P＜0.01).DBE combined with CT identified positive findings in 46(65.7%),which showed no significant difference when compared to DBE alone(P＞0.05).In detecting small bowel abnormalities,DBE showed a sensitivity of 70.8%,a specificity of 94.4%. Conclusions DBE showed a significantly higher diagnostic yield than CT in patients with suspected small bowel disease,and thus should be selected for the initial diagnosis.DBE Combined with CT did not increase the diagnostic yield.However, CT could not only provide direction for intubation with DBE,but also clearly depict the small bowel wall and extraenteric alterations.DBE and CT could compliment each other in examining patients with suspected small bowel disease.