Diagnostic yield of push-type enteroscopy in relation toindication

Background—Push-type enteroscopy, a recent methodfor investigating the small intestine, is currently undergoingassessment. Its diagnostic yield varies in the studies reported to date.
Aim—To assess the diagnostic value of push-typeenteroscopy according to indication.
Patients and methods—From January 1994 toSeptember 1995, 152 consecutive patients (mean age 34 years) underwentpush-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 previousnegative aetiological investigations.
Results—The jejunum and ileum were exploredthrough 120 cm (30-160 cm) and 60 cm (20-120 cm). Digestivebleeding: lesions of the small bowel were found in 6% of the patientswith isolated iron deficiency anaemia and 20% of patients with patentdigestive haemorrhage. Radiological abnormalities of the smallintestine: push-type enteroscopy provided a diagnosis or modified theinterpretation of radiological findings in 18/23 cases (78%). Chronicdiarrhoea and/or malabsorption: push-type enteroscopy yieldedexplanatory findings in four cases (22%). Abdominal pain: push-typeenteroscopy provided no diagnosis.
Conclusion—In this series, push-type enteroscopywas of particular value in investigating patients with radiologicalabnormalities of the small intestine. It was of some value in theexploration of patent digestive haemorrhage or chronic diarrhoea, butnot of abdominal pain. Its value was limited in the exploration of irondeficiency anaemia.

Keywords:enteroscopy; gastrointestinal bleeding