Endoscopy 2009; 41(8): 715-717
DOI: 10.1055/s-0029-1214974
Case report

© Georg Thieme Verlag KG Stuttgart · New York

A retrospective analysis of emergency double-balloon enteroscopy for small-bowel bleeding

K.  Mönkemüller[*] 1 , 2 , H.  Neumann[*] 1 , F.  Meyer3 , R.  Kuhn3 , P.  Malfertheiner1 , L.  C.  Fry1 , 2
  • 1Department of Internal Medicine, Gastroenterology, and Infectious Diseases, Marienhospital, Bottrop, Germany
  • 2Division of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany
  • 3Department of Surgery, Otto von Guericke University, Magdeburg, Germany
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Publikationsverlauf

submitted21 January 2009

accepted after revision18 May 2009

Publikationsdatum:
10. August 2009 (online)

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Although the role of emergency esophagogastroduodenoscopy (EGD) and colonoscopy for upper and lower gastrointestinal bleeding (GIB) is well defined, there are no data on the concept of emergency double-balloon enteroscopy (DBE) for small-bowel bleeding. The aim of this study was to retrospectively evaluate the concept of emergency DBE in overt obscure GIB and assess its impact on patient management. A total of 17 emergency DBEs for overt obscure GIB were carried out in ten patients (six women, four men; mean age 68 years, range 35 – 83). The following diagnoses were made: actively bleeding Dieulafoy lesions of the small bowel, n = 2; bleeding tumors, n = 4 (carcinoids n = 2, adenocarcinoma n = 1, lipoma n = 1); bleeding angiodysplasias and/or large arteriovenous malformation (AVM), n = 2; multiple ulcers, n = 1; and no diagnosis, n = 1. Endoscopic therapies included argon plasma coagulation (n = 6), injection of epinephrine (n = 3), and use of fibrin glue (n = 1). It appears that emergency DBE is technically feasible, facilitates both diagnosis and therapy and enables management of patients with massive overt obscure GIB. This study is a first step in establishing the concept of emergency DBE for patients with suspected small-bowel bleeding.