Skip to main content
Gut logoLink to Gut
. 1998 Mar;42(3):421–425. doi: 10.1136/gut.42.3.421

Diagnostic yield of push-type enteroscopy in relation to indication

B Landi 1, M Tkoub 1, M Gaudric 1, R Guimbaud 1, J Cervoni 1, S Chaussade 1, D Couturier 1, J Barbier 1, C Cellier 1
PMCID: PMC1727050  PMID: 9577352

Abstract

Background—Push-type enteroscopy, a recent method for investigating the small intestine, is currently undergoing assessment. Its diagnostic yield varies in the studies reported to date. 
Aim—To assess the diagnostic value of push-type enteroscopy according to indication. 
Patients and methods—From January 1994 to September 1995, 152 consecutive patients (mean age 34 years) underwent push-type enteroscopy (jejunoscopy, n=93; retrograde ileoscopy, n=17; and double way enteroscopy, n=42). The indications were: unexplained iron deficiency anaemia or macroscopic gastrointestinal bleeding (n=76), radiological abnormalities of the small intestine (n=23), chronic diarrhoea and/or malabsorption syndrome (n=18), abdominal pain (n=12), and miscellaneous (n=23). All patients had undergone previous negative aetiological investigations. 
Results—The jejunum and ileum were explored through 120 cm (30-160 cm) and 60 cm (20-120 cm). Digestive bleeding: lesions of the small bowel were found in 6% of the patients with isolated iron deficiency anaemia and 20% of patients with patent digestive haemorrhage. Radiological abnormalities of the small intestine: push-type enteroscopy provided a diagnosis or modified the interpretation of radiological findings in 18/23 cases (78%). Chronic diarrhoea and/or malabsorption: push-type enteroscopy yielded explanatory findings in four cases (22%). Abdominal pain: push-type enteroscopy provided no diagnosis. 
Conclusion—In this series, push-type enteroscopy was of particular value in investigating patients with radiological abnormalities of the small intestine. It was of some value in the exploration of patent digestive haemorrhage or chronic diarrhoea, but not of abdominal pain. Its value was limited in the exploration of iron deficiency anaemia. 



Keywords: enteroscopy; gastrointestinal bleeding

Full Text

The Full Text of this article is available as a PDF (86.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barkin J. S., Chong J., Reiner D. K. First-generation video enteroscope: fourth-generation push-type small bowel enteroscopy utilizing an overtube. Gastrointest Endosc. 1994 Nov-Dec;40(6):743–747. [PubMed] [Google Scholar]
  2. Barkin J. S., Lewis B. S., Reiner D. K., Waye J. D., Goldberg R. I., Phillips R. S. Diagnostic and therapeutic jejunoscopy with a new, longer enteroscope. Gastrointest Endosc. 1992 Jan-Feb;38(1):55–58. doi: 10.1016/s0016-5107(92)70333-2. [DOI] [PubMed] [Google Scholar]
  3. Berner J. S., Mauer K., Lewis B. S. Push and sonde enteroscopy for the diagnosis of obscure gastrointestinal bleeding. Am J Gastroenterol. 1994 Dec;89(12):2139–2142. [PubMed] [Google Scholar]
  4. Chong J., Tagle M., Barkin J. S., Reiner D. K. Small bowel push-type fiberoptic enteroscopy for patients with occult gastrointestinal bleeding or suspected small bowel pathology. Am J Gastroenterol. 1994 Dec;89(12):2143–2146. [PubMed] [Google Scholar]
  5. Davies G. R., Benson M. J., Gertner D. J., Van Someren R. M., Rampton D. S., Swain C. P. Diagnostic and therapeutic push type enteroscopy in clinical use. Gut. 1995 Sep;37(3):346–352. doi: 10.1136/gut.37.3.346. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Foutch P. G., Sawyer R., Sanowski R. A. Push-enteroscopy for diagnosis of patients with gastrointestinal bleeding of obscure origin. Gastrointest Endosc. 1990 Jul-Aug;36(4):337–341. doi: 10.1016/s0016-5107(90)71060-7. [DOI] [PubMed] [Google Scholar]
  7. Gostout C. J. Enteroscopy for unexplained iron-deficiency anemia: identifying the patient with sprue. Gastrointest Endosc. 1993 Jan-Feb;39(1):76–79. doi: 10.1016/s0016-5107(93)70018-8. [DOI] [PubMed] [Google Scholar]
  8. Green J. A., Barkin J. S., Gregg P. A., Kohen K. Ulcerative jejunitis in refractory celiac disease: enteroscopic visualization. Gastrointest Endosc. 1993 Jul-Aug;39(4):584–585. doi: 10.1016/s0016-5107(93)70182-0. [DOI] [PubMed] [Google Scholar]
  9. Harris A., Dabezies M. A., Catalano M. F., Krevsky B. Early experience with a video push enteroscope. Gastrointest Endosc. 1994 Jan-Feb;40(1):62–64. doi: 10.1016/s0016-5107(94)70011-7. [DOI] [PubMed] [Google Scholar]
  10. Landi B., Cellier C., Fayemendy L., Cugnenc P. H., Barbier J. P. Duodenal perforation occurring during push enteroscopy. Gastrointest Endosc. 1996 Jun;43(6):631–631. doi: 10.1016/s0016-5107(96)70211-0. [DOI] [PubMed] [Google Scholar]
  11. Lewis B. S., Waye J. D. Chronic gastrointestinal bleeding of obscure origin: role of small bowel enteroscopy. Gastroenterology. 1988 May;94(5 Pt 1):1117–1120. doi: 10.1016/0016-5085(88)90001-7. [DOI] [PubMed] [Google Scholar]
  12. Lewis B. S., Waye J. D. Small bowel enteroscopy in 1988: pros and cons. Am J Gastroenterol. 1988 Aug;83(8):799–802. [PubMed] [Google Scholar]
  13. Pennajzio M., Arrigoni A., Rossini F. P. Push type enteroscopy for small bowel tumors. Gastrointest Endosc. 1995 May;41(5):524–525. doi: 10.1016/s0016-5107(05)80020-3. [DOI] [PubMed] [Google Scholar]
  14. Pennazio M., Arrigoni A., Risio M., Spandre M., Rossini F. P. Clinical evaluation of push-type enteroscopy. Endoscopy. 1995 Feb;27(2):164–170. doi: 10.1055/s-2007-1005656. [DOI] [PubMed] [Google Scholar]
  15. Tada M., Kawai K. Small-bowel endoscopy. Scand J Gastroenterol Suppl. 1984;102:39–52. [PubMed] [Google Scholar]
  16. Yang R., Laine L. Mucosal stripping: a complication of push enteroscopy. Gastrointest Endosc. 1995 Feb;41(2):156–158. doi: 10.1016/s0016-5107(05)80601-7. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES