推进式双气囊电子小肠镜在小肠疾病诊断中的应用

目的　通过对不明原因小肠疾病患者行双气囊电子小肠镜检查 ,评价其安全性、检查范围、临床价值及耐受性。方法　 2 0 0 3年 4月至 7月 ,30例多项常规检查阴性、疑患小肠疾病的患者接受检查 ,其中不明原因消化道出血 2 0例、腹痛待查 5例、腹泻待查 3例及不完全性小肠梗阻 2例。结果　双气囊电子小肠镜抵达空回肠交界部、回肠中下段和末端回肠的分别为 9、17和 4例 ,检查所用平均时间分别为 (40 .5± 12 .3)、(6 4 .3± 18.6 )和 (78.8± 11.5 )min ;绝大部分患者对检查的耐受性良好 ;2 5例患者检出阳性病灶 ,整体阳性率为 83.3% ;不明原因消化道出血的病因确诊率为 80 .0 % ,腹痛、腹泻阳性诊断分别为 4 / 5例和 1/ 3例 ,2例不完全小肠梗阻均获明确诊断 ;未见操作相关的严重不良反应和并发症。结论　双气囊电子小肠镜是一种安全、可靠、有较高临床诊断价值的小肠疾病检查手段。     

双气囊内镜对小肠疾病的诊断及治疗

目的 评价双气囊内镜(DBE)对小肠疾病的诊断和治疗价值及其检查的安全性.方法 2005年12月～2007年7月,我院对37例疑诊小肠疾病的患者行DBE检查,其中不明原因消化道出血25例.结果 37例患者发现病灶29例,病灶包括小肠肿瘤、炎症性肠病、小肠血管畸形、小肠憩室和小肠重复畸形等.其中24例经病检、手术或治疗效果确诊,准确性为95.8%.1例并发急性胰腺炎.结论 DBE对小肠疾病的检出率高,并可开展内镜下治疗,具有较高的临床应用价值.     

双气囊内镜对小肠息肉的内镜诊治研究

目的 探讨双气囊内镜(DBE)对小肠息肉镜下治疗的可行性及安全性.方法 回顾分析我院自2003年11月～2009年6月接受DBE检查并检出小肠息肉的所有病例,总结和分析小肠息肉的内镜诊断及治疗情况,并评价其安全性.结果 360例患者,共进行566例次DBE检查及治疗,其中检出小肠息肉患者66例(Peutz-Jeghers综合征患者50例,其他小肠息肉患者16例).66例患者共接受122例次DBE镜下治疗(经口 74次,经肛48次).镜下切除小肠息肉共计1 012枚(直径5～10 mm 95枚、1～30mm 599枚,直径31～50 mm 274枚,直径大于50 mm 44枚).66例患者在DBE检查及治疗前86例次有不同的临床症状(不完全肠梗阻36例、消化道出血32例、腹痛及腹部不适18例),其中78例次(90.7%)经内镜治疗后临床症状均明显缓解或消失,另有8例次因小肠息肉巨大(7例)或发现息肉恶变(2例)转外科手术治疗.发生较严重的并发症共6例次(小肠穿孔3例,术后有3例出现引起血红蛋白水平下降的消化道出血).结论 DBE能安全有效地切除小肠多发息肉,可在一定范围内代替外科手术治疗,为小肠息肉患者提供了一种安全有效的微创治疗方法,具有重要的临床应用价值.     

推进式双气囊电子小肠镜在小肠疾病诊断中的评估

目的 评价推进式双气囊电子小肠镜(double-balloon push enteroscopy，DBE)在小肠疾病诊断中的价值。方法 总结22例疑小肠疾病DBE检查的临床资料，上述患者均经胃镜、肠镜、X线钡餐、小肠钡剂灌肠和血管造影等检查未发现异常。结果 22例共行DBE检查26例次(15例次接受了口侧进镜，11例次接受了肛侧进镜)，每侧进镜术程平均80min。DBE检查共发现异常14例，检出率为63．6％。其中不明原因消化道出血10例，DBE检出病变6例；腹痛和(或)呕吐待查7例，DBE检出病变5例；慢性腹泻待查4例，DBE检出病变2例；不明原因不完全性肠梗阻1例，DBE检出病变1例。口侧进镜患者，术中多数出现恶心、消化液自口经外套管口溢出，偶尔出现一过性轻微腹痛；肛侧进镜患者无明显不适及反应，未出现出血、穿孔等并发症。结论 DBE作为一种新型小肠疾病检查手段，明显优于传统的检查方法，可重复直视操作下观察病灶，通过活检对病变进行定性检查，具有安全、可控性、直视和图像清晰等优点，在诊断小肠疾病方面更具有优越性。     

The diagnostic value of double-balloon enteroscopy in children with small bowel disease: Report of 31 cases

BACKGROUND AND OBJECTIVE:

Before the introduction of double-balloon enteroscopy (DBE), it was impossible to visualize the entire small bowel. Its diagnostic yield has been assessed in adults, but not yet in children. The present retrospective study evaluated the diagnostic usefulness and safety of DBE in children with suspected small bowel disease.

METHODS:

Between June 2003 and June 2007, 31 patients (19 boys and 12 girls, age range three to 14 years) with suspected small bowel disease underwent DBE after receiving negative evaluations using other diagnostic modalities.

RESULTS:

There were no severe complications. In two patients, the entire small bowel was viewed using oral and anal approaches, and for the remaining 29 patients, only one approach was used. The sites of disease in were identified in 25 of 31 cases (80.65%). The bleeding source was found in 21 of 27 patients with obscure gastrointestinal bleeding (diagnostic rate of 77.78%). Different diseases were identified in four children with chronic diarrhea.

CONCLUSION:

DBE is a safe and effective method to diagnose patients with suspected small bowel disorders.     

胶囊内镜与双气囊内镜诊断小肠疾病的比较

目的比较胶囊内镜和双气囊内镜对小肠疾病的检出率和诊断准确性，探讨其联合应用的临床意义。方法对116例不明原因消化道出血和102例不明原因腹痛或腹泻患者，共218例进行内镜检查。其中165例首选胶囊内镜，53例首选双气囊内镜。对胶囊内镜检查阴性或可疑病变者建议双气囊内镜检查，反之亦然。比较两种检查方法对小肠疾病的检出率、诊断率以及患者依从性、不良反应发生率等。结果1例胶囊内镜和2例双气囊内镜操作失败。51例患者行64次双气囊内镜检查，其中34例经口、4例经肛检查，13例分别接受经口和经肛检查。胶囊内镜对小肠病变的总检出率及对不明原因消化道出血的小肠疾病检出率（72．0％和88．0％），均明显高于双气囊内镜（41．2％和60．0％），诊断率也高于后者（51．8％和39．2％）。5例胶囊内镜检查阴性再经双气囊内镜检查者中，1例发现病灶；15例胶囊内镜检查怀疑小肠病变者中，12例经双气囊内镜结合活检病理确诊。而3例双气囊内镜未发现异常者再经胶囊内镜检查发现小肠病变。所有患者均未发生严重不良反应。结论胶囊内镜对小肠疾病检出率高，可作为怀疑小肠疾病，尤其是不明原因消化道出血的首选检查方法；双气囊内镜在胶囊内镜检查阴性者中仍可发现部分病灶，并能明确多数胶囊内镜下可疑病变，可作为胶囊内镜检查后的补充检测手段。     

双气囊电子镜在小肠疾病诊断与治疗中的作用

目的探讨双气囊电子镜在小肠疾病诊断和治疗中的意义。方法对116例疑似小肠疾病患者采用双气囊电子镜，观察记录检查时间、检查阳性率、诊断结果等情况。结果116例患者共确诊111例，阳性率为95．6％，其中不明原因的小肠出血占49．1％（57／116），平均用时45min。5例进行了全胃肠检查，患者可以很好的耐受检查。5例因进镜困难而放弃检查。大多数器质性疾病（除了病变部位有活动性出血）患者均有病理诊断。1例胃大部切除患者发生肠扭转造成肠梗阻，在完成检查后，完全恢复。结论双气囊电子镜能够肉眼观察全小肠，并能够得到病理诊断，对病变进行大体定位。     

双气囊小肠镜在68例小肠疾病诊断中的价值

目的 评价双气囊小肠镜对小肠疾病的诊断价值及安全性和耐受性.方法 2003年5月至2005年7月,对68例经常规检查无异常发现、疑患小肠疾病患者进行双气囊小肠镜检查,其中不明原因反复消化道出血39例、不完全性小肠梗阻7例、慢性腹痛14例、慢性腹泻8例.结果 68例患者中,36例经口进镜,25例经肛进镜,7例患者分别经口及经肛进镜检查.除3例因肠腔狭窄中止进镜外,其余病例均能检查1/2-3/4的小肠,7例患者结合经口及经肛途径完成全小肠检查.68例患者中41例检出阳性病灶,总阳性率为60.3%;其中不明原因消化道出血阳性率为62.6%（26/39）,不完全性小肠梗阻阳性5例,慢性腹痛阳性率为43%（6/14）,慢性腹泻阳性4例.除11例经口进镜者行异丙芬静脉全身麻醉外,其他经口及经肛进镜患者均能耐受整个检查,未出现出血、穿孔等严重并发症.结论 双气囊小肠镜是一种对小肠疾病诊断价值较高、安全可靠的检查手段.     

双气囊小肠镜对小肠出血的诊断价值

目的探讨双气囊小肠镜对小肠出血的诊断价值及安全性。方法对2007年1月-2008年12月我院经常规检查怀疑为小肠出血的56例患者行双气囊小肠镜检查,分别接受经口或经肛双气囊小肠镜检查。主要分析检查时间、内镜插入深度、确诊情况和并发症发生率。结果所有患者无严重并发症,操作时间为35-150 min,平均（76±22）min;平均插入小肠长度经口和经肛分别为（254±126）cm和（182±103）cm。小肠病变中阳性发现46例（82.1%）,主要包括血管畸形、小肠溃疡、克罗恩病、慢性非特异性炎症、肿瘤、息肉及憩室等。结论双气囊小肠镜检查安全有效,为小肠出血疾病的诊断提供了新的手段。     

胶囊内镜与双气囊小肠镜对小肠疾病诊断的荟萃分析

目的比较胶囊内镜和双气囊小肠镜对小肠疾病的阳性检出率。方法从Medline、Embase、Elsevier Science Direct和中国期刊全文数据库中检索比较胶囊内镜和双气囊小肠镜对小肠疾病阳性检出率的前瞻性研究。对各项研究中2种内镜的阳性检出率比数比（OR）行荟萃分析，经异质性检验后采用固定效应模型或随机效应模型进行统计分析。并根据可能产生异质性的原因进行分层分析。结果共有8项研究入选（n=277）。荟萃结果表明，胶囊内镜和双气囊小肠镜对小肠疾病阳性检出率没有显著差别[170／277比156／277，随机效应模式：OR为1．21（95％可信区间CI：0．64，2．29）]。分层分析提示：胶囊内镜的阳性率显著高于未采用经口和经肛这2种进镜方式相结合的双气囊小肠镜[137／219比110／219，固定效应模式：OR为1．67（95％CI：1．14，2．44），（P〈0．01）]；而低于用这2种进镜方式相结合的双气囊小肠镜检查，但差异没有统计学意义[26／48比37／48，随机效应模式：OR0．33（95％CI：0．05，2．21），（P〉0．05）]。进一步对5项全文发表的关于对不明原因消化道出血诊断的研究进行荟萃，结果仍然提示胶囊内镜的阳性检出率明显高于未采用经口和经肛这2种进镜方式相结合的双气囊小肠镜[118／191比96／191，固定效应模式：OR1．61（95％CI：1．07，2．43），（P〈0．05）]，但显著低于2种进镜方式相结合的双气囊小肠镜检查[11／24比21／24，固定效应模式：OR0．12（95％CI：0．03，0．52），（P〈0．01）]。结论双气囊小肠镜经口和经肛2种进镜方式联合应用的阳性率可能高于胶囊内镜，对这2种内镜的选择，应该取决于病人的一般状况及其意愿，医疗单位所具备的能力，以及病灶是否可能需要采取进一步的介入治疗。     

胶囊内镜序贯联合双气囊小肠镜诊断小肠出血

目的评价胶囊内镜(capsule endoscopy,CE)序贯联合双气囊小肠镜(double-balloon enteroscopy,DBE)检查对小肠出血疾病(small intestine bleeding,SIB)的临床诊断价值。方法回顾性分析106例行CE检查及部分序贯联合DBE检查SIB患者的临床资料。结果 106例SIB患者病因明确诊断率为96.2%(102/106),以肠黏膜糜烂、溃疡性病变25.5%(27/106)、血管病变24.5%(26/106)、小肠肿瘤、隆起病变23.6%(25/106)最常见;行CE和DBE检查的病变检出率分别为89.6%(95/106)、96.2%(50/52),病因诊断率分别为50.9%(54/106)、92.3%(48/52),DBE检查病因诊断率显著高于CE检查,差异有统计学意义(P0.01);CE和DBE检查发现血管病变、肿瘤隆起病变与憩室分别为22.6%(24/106)、0.9%(1/106)和51.9%(27/52)、15.4%(8/52),DBE对血管病变、肿瘤隆起病变与憩室病因的诊断率高于CE,二者比较差异有统计学意义(P0.05)。结论在小肠出血患者中CE检查对血管病变、肿瘤隆起病变与憩室的病因诊断低于DBE检查;CE序贯联合DBE检查应用能提高小肠出血疾病的病变检出率及病因诊断率。     

胶囊内镜结合双气囊内镜检查在小肠疾病诊断中的作用

目的 探讨胶囊内镜结合双气囊内镜检查在小肠疾病诊断中的作用.方法 连续调查299例因不明原因消化道出血或腹痛、腹泻等原因而行胶囊内镜检查者,对胶囊内镜阴性或诊断不确定者建议双气囊内镜检查.分析胶囊内镜后双气囊内镜检查者诊断和随访资料.结果 296例完成胶囊内镜检查,发现阳性138例(46.6%),可疑阳性68例(23.0%),阴性90例(30.4%).45例胶囊内镜可疑阳性者和7例阴性者接受双气囊内镜检查,分别检出31例和1例小肠病变.双气囊内镜可能存在假阴性结果8例,未发现假阳性者;胶囊内镜可能存在假阴性结果2例,并有8例假阳性.在胶囊内镜结果提示下,90.3%(28/31)患者经单侧双气囊内镜检查即发现病灶.平均随访期为17个月,93.5%的双气囊内镜明确诊断者得到有效治疗.二种检查方法耐受性好,无严重不良反应发生.结论 胶囊内镜对小肠病变检出率高,但其诊断不确定性也较高.双气囊内镜能明确大部分胶囊内镜可疑阳性者.胶囊内镜结合双气囊内镜检查的诊断策略能提高小肠疾病诊断率、指导治疗并改善患者预后.     

A case of small bowel adenocarcinoma in a patient with Crohn's disease detected by PET/CT and double-balloon enteroscopy

Small bowel adenocarcinoma (SBA) in patients with Crohn's disease (CD) is quite rare, difficult to diagnose without surgery, and has a poor prognosis. Here, we report a 48-year-old man with SBA and a 21-year history of CD who was diagnosed by a combination of positron emission tomography/computed tomography (PET/CT) and double-balloon enteroscopy (DBE). Since the age of 27 years, the patient had been treated for ileal CD and was referred to our hospital with persistent melena. Multiple hepatic tumors were found by CT. PET/CT detected an accumulation spot in the small bowel. DBE revealed an ulcerative tumor in the ileum about 100 cm from the ileocecal valve. An endoscopic forceps biopsy specimen showed poorly differentiated adenocarcinoma. There were some longitudinal ulcer scars near the tumor, and the chronic inflammation in the small bowel appeared to be associated with the cancer development. Previous reports suggest the risk of SBA in patients with CD is higher than in the overall population. Since early diagnosis is extremely difficult in these cases, novel techniques, such as PET/CT and DBE, may be expected to help in making a preoperative diagnosis of the development of SBA in CD.     

双气囊小肠镜与胶囊内镜诊断小肠出血病因比较

目的比较双气囊小肠镜和胶囊内镜在小肠出血中的诊断准确率和实用价值。方法24例原因不明的可疑小肠出血患者分别接受双气囊小肠镜和胶囊内镜检查。双气囊小肠镜首选进镜方式分为经口或经肛2种，首选方式检查后未发现病灶者，日后改换进镜方式再行检查。胶囊内镜采用以色列GIVEN公司产品。2种检查方法分别由专门医师独立操作并诊断，最后进行汇总比较。结果24例患者中21例通过小肠镜检查发现病灶，总检出率为87．5％。24例患者行胶囊内镜检查后，有阳性发现者11例(45．8％)，另13例无异常发现。双气囊小肠镜检查发现的阳性病灶均经活检病理和手术探查证实，其病因诊断准确率为87．5％，胶囊内镜诊断准确率为25％。在耐受性评估方面，胶囊内镜和全麻下经口进镜的耐受性最佳，以后依次为非麻醉经肛方式和非麻醉经口方式。所有小肠镜和胶囊内镜检查者中未见操作相关的严重不良反应。结论①经口和经肛方式结合能使双气囊小肠镜完成对全小肠的检查。②双气囊小肠镜在不明原因小肠出血的病因诊断方面明显优于胶囊内镜检查。③胶囊内镜在小肠多节段病变和长段病变的诊断上仍有一定价值。④胶囊内镜和全麻下经口双气囊小肠镜检查是一项易为患者接受的、安全的检查方法。     

双气囊小肠镜在小肠常见疾病中的临床应用

双气囊小肠镜(double-balloon enteroscopy,DBE)的临床应用,能够到达传统内镜检查的盲区。相对于传统的检查手段,DBE在小肠常见疾病中有很高的诊断率,同时可行镜下取活体组织送检病理及治疗,高效安全。本文就DBE在小肠常见疾病中的临床应用价值研究方面的进展作一概述。     

双气囊小肠镜在小肠克罗恩病中的诊断价值研究

目的 探讨双气囊小肠镜在小肠克罗恩病(CD)诊断中的价值.方法 回顾性总结141例临床怀疑小肠CD行双气囊小肠镜检查患者的临床资料,以病理诊断结合内镜表现和临床随访结果为最终诊断结果,对比分析小肠CD双气囊小肠镜、CT小肠成像以及胶囊内镜的检出率和确诊率.结果 双气囊小肠镜检出小肠CD 128例,检出率为90.8％( 128/141),最终经病理及临床随访确诊126例,确诊率为98.4％ (126/128);CT小肠成像检出小肠CD 19例,检出率为76.0％( 19/25),最终经病理及临床随访确诊17例,确诊率为89.5％ (17/19);胶囊内镜镜检出小肠CD 15例,检出率为60.0％( 15/25),最终经病理及临床随访确诊14例,确诊率为93.3％ (14/15).双气囊小肠镜组小肠CD检出率和确诊率均高于胶囊内镜和CT小肠成像.结论 双气囊小肠镜在小肠CD诊断中具有较好的应用价值,对存在内镜检查禁忌证者CT小肠成像可作为首选辅助检查手段.     

Double-balloon enteroscopy for mesenchymal tumors of small bowel:Nine years’ experience

AIM:To assess the value of double-balloon enteroscopy(DBE) for the diagnosis of gastrointestinal mesenchymal tumors(GIMTs) in the small bowel and clarify their clinical and endoscopic characteristics.METHODS:A retrospective review in a total of 783 patients who underwent a DBE procedure from January 2003 to December 2011 was conducted.Data from patients with pathologically confirmed GIMTs were analyzed at a single tertiary center with nine years’ experience.The primary outcomes assessed included characteristics of patients with GIMTs,indications for DBE,overall diagnostic yield of GIMTs,endoscopic morphology,positive biopsy,comparison of diagnosis with capsule endoscopy,and subsequent interventional management.RESULTS:GIMTs were identified and analyzed in 77 patients.The mean age was 47.74 ± 14.14 years(range:20-77 years),with 63.6% being males.The majority of individuals presented with gastrointestinal bleeding,accounting for 81.8%,followed by abdominal pain,accounting for 10.4%.Small bowel pathologies were found in 71 patients,the detection rate was 92.2%.The diagnostic yield of DBE for GIMTs was 88.3%.DBE was superior to capsule endoscopy in the diagnosis of GIMTs(P = 0.006;McNemar’s χ2 test).Gastrointestinal stromal tumor was the most frequent and leiomyoma was the second frequent GIMT.Single and focal lesions were typical of GIMTs,and masses with smooth or unsmooth surface were the most common in the small bowel.GIMTs were removed from all the patients surgically except one patient treated with endoscopic resection.CONCLUSION:DBE is a safe and valuable procedure for patients with suspected GIMTs,and it provides an accurate position for subsequent surgical intervention.     

双气囊电子小肠镜临床应用初探

目的探讨小肠疾病检查新方法——双气囊电子小肠镜的操作、诊断效果、适应证等问题。方法应用双气囊电子小肠镜对13例疑诊小肠疾病的患者进行双气囊小肠镜检查。分别从口侧或肛侧进镜，利用外套管、内镜前端的双气囊交替充气、放气和交替滑进，推进小肠镜进入小肠检查。记录检查范围、时间、耐受性及病变等。结果13例患者共行小肠镜检查19例次(11例次接受了口侧进镜，8例次接受了肛侧进镜)，每侧进镜术程平均80min。从口侧进镜均达第3～6组小肠，从肛侧进镜达4～6组小肠。发现空肠良性问质瘤1例、空肠淋巴瘤1例、回肠溃疡狭窄及憩室2例、空肠息肉2例、空肠糜烂2例。口侧进镜患者，术中多数出现恶心、消化液自口及外滑管口溢出，偶尔出现一过性轻微腹痛；肛侧进镜患者无明显不适及反应；未出现出血、穿孔等并发症。结论双气囊小肠镜是一种新型小肠疾病检查手段，平均2～3h可检查完所有小肠，进镜迅速。于操作直视下观察病变，通过活检对病变进行定性检查。病变检出率明显优于小肠钡剂造影，具有安全、可控性、直视、图像清晰等优点，适用于无肠粘连及严重脏器功能不全的小肠疾病患者。     

Double-balloon enteroscopy in small bowel tumors: A Chinese single-center study

AIM: To analyze the clinical characteristics of small bowel tumors detected by double-balloon enteroscopy (DBE) and to evaluate the diagnostic value of DBE in tumors. METHODS: Four hundred and forty consecutive DBE examinations were performed in 400 patients (250 males and 150 females, mean age 46.9 ± 16.3 years, range 14-86 years) between January 2007 and April 2012. Of these, 252 patients underwent the antegrade approach, and 188 patients underwent the retrograde approach. All the patients enrolled in our study were suspected of having small bowel diseases with a negative etiological diagnosis following other routine examinations, such as upper and lower gastrointestinal endoscopy and radiography tests. Data on tumors, such as clinical information, endoscopic findings and opera-tion results, were retrospectively collected. RESULTS: Small bowel tumors were diagnosed in 78 patients, of whom 67 were diagnosed using DBE, resulting in a diagnostic yield of 16.8% (67/400); the other 11 patients had negative DBE findings and were diagnosed through surgery or capsule endoscopy. Adenocarcinoma (29.5%, 23/78), gastrointestinal stromal tumor (24.4%, 19/78) and lymphoma (15.4%, 12/78) were the most common tumors. Among the 78 tumors, 60.3% (47/78) were located in the jejunum, and the overall number of malignant tumors was 74.4% (58/78). DBE examinations were frequently performed in patients with obscure gastrointestinal bleeding (47.4%) and abdominal pain (24.4%). The positive detection rate for DBE in the 78 patients with small bowel tumors was 85.9% (67/78), which was higher than that of a computed tomography scan (72.9%, 51/70). Based on the operation results, the accuracy rates of DBE for locating small bowel neoplasms, such as adenocarcinoma, gastrointestinal stromal tumor and lymphoma, were 94.4%, 100% and 100%, respectively. The positive biopsy rates for adenocarcinoma and lymphoma were 71.4% and 60%, respectively. CONCLUSION: DBE is a useful diagnostic tool with high clinical practice value and should be consider     

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

AIM: To compare the roles of capsule endoscopy(CE)and double-balloon enteroscopy(DBE) in the diagnosis of obscure small bowel diseases.METHODS: From June 2009 to December 2014, 88 patients were included in this study; the patients had undergone gastroscopy, colonoscopy, radiological small intestinal barium meal, abdominal computed tomography or magnetic resonance imaging scan and mesenteric angiography, but their diagnoses were still unclear. The patients with gastrointestinal obstructions,fistulas, strictures, or cardiac pacemakers, as well as pregnant women, and individuals who could not accept the capsule-retention or capsule-removal surgery were excluded. Patients with heart, lung and other vital organ failure diseases were also excluded. Everyone involved in this study had undergone CE and DBE. The results were divided into:(1) the definite diagnosis(the diagnosis was confirmed at least by one of the biopsy,surgery, pathology or the drug treatment effects with follow-up for at least 3 mo);(2) the possible diagnosis(a possible diagnosis was suggested by CE or DBE,but not confirmed by the biopsy, surgery or follow-up drug treatment effects); and(3) the unclear diagnosis(no exact causes were provided by CE and DBE for the disease). The detection rate and the diagnostic yield of the two methods were compared. The differencein the etiologies between CE and DBE was estimated,and the different possible etiologies caused by the age groups were also investigated.RESULTS: CE exhibited a better trend than DBE for diagnosing scattered small ulcers(P = 0.242, Fisher's test), and small vascular malformations(χ 2 = 1.810,P = 0.179, Pearson χ 2 test), but with no significant differences, possible due to few cases. However,DBE was better than CE for larger tumors(P =0.018, Fisher's test) and for diverticular lesions with bleeding ulcers(P = 0.005, Fisher's test). All three hemangioma cases diagnosed by DBE in this study(including sponge hemangioma, venous hemangioma,and hemangioma with hamartoma lesions) were all confirmed by biopsy. Two parasite cases were found by CE, but were negative by DBE. This study revealed no obvious differences in the detection rates(DR) of CE(60.0%, 53/88) and DBE(59.1%, 52/88). However,the etiological diagnostic yield(DY) difference was apparent. The CE diagnostic yield was 42.0%(37/88),and the DBE diagnostic yield was 51.1%(45/88).Furthermore, there were differences among the age groups(χ 2 = 22.146, P = 0.008, Kruskal Wallis Test). Small intestinal cancer(5/6 cases), vascular malformations(22/29 cases), and active bleeding(3/4cases) appeared more commonly in the patients over50 years old, but diverticula with bleeding ulcers were usually found in the 15-25-year group(4/7cases). The over-25-year group accounted for the stromal tumors(10/12 cases).CONCLUSION: CE and DBE each have their own advantages and disadvantages. The appropriate choice depends on the patient's age, tolerance, and clinical manifestations. Sometimes CE followed by DBE is necessary.