Utility of single- and double-balloon enteroscopy

Single- and double-balloon enteroscopes have similar efficacy. The entire small bowel can be examined through the oral route in 60-90 minutes in 25-40% of patients. Using the oral and rectal. routes, complete examinations can be performed in 75% of patients The diagnostic indications are mid-gastrointestinal bleeding tumors, Crohn's disease, intestinal obstruction and atypical malabsorption. Therapeutic indications include access to enterostomy, hemostasis, foreign body withdrawal, dilatation and polypectomy in the small bowel. This procedure is also useful to place enteral feeding tubes in patients with an excluded stomach. Hemostatic efficacy is high in patients with elevated transfusional requirements. For polypectomy, this technique has not been demonstrated to have the same efficacy/risk as colonoscopy. Complications include pancreatitis (0.34%) and perforation (0.34-6.4%). The level of evidence for almost all indications is low, since few prospective and homogeneous studies have been performed. (C) 2008 Elsevier Espana, S.L. All rights reserved.