Usefulness of EUS with double-balloon enteroscopy for diagnosis of small-bowel diseases

BACKGROUND: Until recently, EUS of the small bowel has been performed only in limited regions because of difficulties in endoscopically approaching the small bowel. Double-balloon enteroscopy (DBE) now permits investigation of the entire small bowel. OBJECTIVE: To evaluate the usefulness of EUS with DBE for diagnosis of small-bowel diseases. DESIGN: Pilot study. SETTING: All patients were examined at Hiroshima University Hospital. PATIENTS: EUS with DBE was performed in 20 consecutively analyzed patients (14 men, 6 women; mean age, 47.6 +/- 3.8 years). DBE was performed to investigate obscure GI bleeding (n = 12), small-bowel diseases suggested by other modalities (n = 7), recurring ileus (n = 1), or follow-up (n = 1). INTERVENTIONS: Endoscopic biopsies were performed as clinically indicated. MAIN OUTCOME MEASUREMENTS: EUS image quality for various types of small-bowel diseases and comparison with abdominal US. RESULT: Protruding lesions were detected in 7 examinations, ulcerative lesions in 7, and no abnormalities in 7. EUS could be performed in 20 of 21 examinations. These images were adequately detailed evaluations and with more detail than US images in 16 examinations. LIMITATION: Small nonblinded study. CONCLUSIONS: EUS with DBE offers high-resolution cross-sections of small-bowel lesions and may contribute to the diagnosis of small-bowel diseases.