Endoscopy 2008; 40(10): 835-842
DOI: 10.1055/s-2008-1077594
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© Georg Thieme Verlag KG Stuttgart · New York

Small-bowel endoscopy

M.  Pennazio1
  • 1Division of Gastroenterology 2, Department of Internal Medicine, S. Giovanni AS University Teaching Hospital, Turin, Italy
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Publication History

Publication Date:
30 September 2008 (online)

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Introduction

Small-bowel endoscopy remains a particularly attractive subject for clinical research and debate. A total of 111 scientific contributions on this topic were presented at this year’s Digestive Diseases Week, 58 of which concerned capsule endoscopy and 53 flexible enteroscopy, the latter mainly balloon-assisted. Alongside various reports concerning technical aspects, new methods of enteroscopy and the clinical application of new capsules were also described.

Obscure bleeding is still the field in which small-bowel endoscopy finds greatest clinical application, whereas several important issues remain to be clarified regarding the use of capsule endoscopy in patients with Crohn’s disease, including safety and clinical usefulness. The possibility of carrying out endoscopic treatment is certainly the most exciting feature of flexible enteroscopy, coagulation of small-bowel angioectasias being the most commonly performed. There were also some reports regarding balloon dilation of small-bowel Crohn’s strictures, endoscopic resections within the small bowel, and endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically modified anatomy; however, these studies still only relate to small series, with short follow-up, and most of them are retrospective. Clinical outcome studies as well as cost-effectiveness analyses for the various indications are needed.