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Y Bouhnik Hôpital
Saint-Lazare, Paris, France
Correspondence to: Dr Y Bouhnik, Hôpital Saint-Lazare, 107 bis rue du Faubourg
Saint-Denis, 75475 Paris Cedex 10, France. Accepted for publication 9 February 1998 Aims Keywords:
enteroscopy;
small intestine;
gastrointestinal
bleeding;
anaemia;
chronic diarrhoea;
intestinal tumour
To evaluate the diagnostic
yield and safety of a new push type videoenteroscope (PVE) for
diagnosis of small bowel disease.
MethodsThree hundred and thirteen
patients were referred for one or two way PVE from December 1993 to
June 1996. Indications for PVE were: an unexplained iron deficiency
anaemia with or without clinically evident gastrointestinal bleeding;
or a complementary investigation for suspected small bowel disease,
after a small bowel barium follow through (SBBFT) considered as normal
or abnormal, but without a definite diagnosis.
ResultsA jejunoscopy and a
retrograde ileoscopy were carried out in 306 and 234 patients,
respectively. In patients with isolated anaemia (n=131) and those with
clinically evident gastrointestinal bleeding associated anaemia (n=72),
PVE provided a diagnosis in 26 (19.8%) and 22 (30.5%) cases,
respectively. Lesions found were located in the jejunoileum in 30 (14.7%) patients and in the gastroduodenum or the colon in 18 (8.8%)
patientsthat is, within the reach of the conventional
gastroscope/colonoscope. In patients with normal (n=54) or abnormal
(n=56) SBBFT, PVE provided a diagnosis in 17 (31%) and 27 (48%)
cases, respectively. In 25% of cases, the abnormal appearance of SBBFT
was not confirmed. The site of the radiological abnormality was not
reached in 27% of cases. Lesions were located at the jejunum and the
ileum in 59 (64%) and 33 (36%) cases, respectively.
ConclusionsPVE is useful in around
30% of cases of unexplained anaemia or after an SBBFT which failed to
provide an accurate aetiological diagnosis. Use of retrograde
videoenteroscopy increases diagnostic yield by one third.
(GUT 1998;43:280-284)
© 1998 by Gut
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  R Sidhu, D S Sanders, A J Morris, and M E McAlindon Guidelines on small bowel enteroscopy and capsule endoscopy in adults Gut, January 1, 2008; 57(1): 125 - 136. [Full Text] [PDF]
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P D Thomas, A Forbes, J Green, P Howdle, R Long, R Playford, M Sheridan, R Stevens, R Valori, J Walters, et al. Guidelines for the investigation of chronic diarrhoea, 2nd edition Gut, July 1, 2003; 52(90005): v1 - 15. [Full Text]
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 J M T Willoughby and S M Laitner Audit of the investigation of iron deficiency anaemia in a district general hospital, with sample guidelines for future practice Postgrad. Med. J., April 1, 2000; 76(894): 218 - 222. [Abstract] [Full Text]
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