Safety Of Balloon-assisted Enteroscopy Research Articles

Utility and safety of balloon-assisted enteroscopy in patients with left ventricular assist devices: a retrospective multicenter study

Objective and study aims Patients with left-ventricular assist devices (LVADs) have an increased risk of gastrointestinal bleeding, especially from the small bowel, often necessitating evaluation with balloon-assisted enteroscopy (BAE). Our study aimed to assess the periprocedural safety and utility of BAE for gastrointestinal bleeding in patients with LVADs. Patients and methods This was a multicenter retrospective cohort study of adults with LVADs who underwent BAE between January 2007 to December 2018. Results Thirty-four patients underwent a total of 46 BAEs (9 were single-balloon enteroscopies [SBEs] and 37 were double-balloon enteroscopies [DBEs]). Mean age of patients was 66.4 ± 8.3 years. Patients tolerated anesthesia well, without complications. There were no complications from the BAE itself. One patient required repeat BAE due to a progressive drop in hemoglobin and another patient developed paroxysmal supraventricular tachycardia. One patient died within 72 hours of the procedure due to worsening of LVAD thrombosis. Diagnostic yields were 69.6 % for all procedures, 73.0 % for DBE and 55.6 % for SBE ( P = 0.309). Therapeutic yields were 67.4 % overall: 73.0 % for DBE and 44.4 % for SBE ( P = 0.102). In those that presented with overt gastrointestinal bleeding, DBE had a higher diagnostic yield compared to SBE (84.2 % vs. 42.9 %; P = 0.057) and a significantly higher therapeutic yield (84.2 % vs. 28.6 %; p = 0.014). Conclusions This is the largest multicenter study of patients with LVADs who underwent DBE. BAE appears to be a safe and useful modality for the evaluation of gastrointestinal bleeding in these patients.

Primary experience of small bowel polypectomy with balloon-assisted enteroscopy in young pediatric Peutz–Jeghers syndrome patients

For Peutz-Jeghers syndrome (PJS) patients, small bowel polyps develop and result in symptoms at an early age. Balloon-assisted enteroscopy (BAE) is verified as a safe and efficient choice to evaluate and remove small intestinal polyps in adult PJS. But the safety of BAE, especially BAE-facilitated polypectomy for young pediatrics, is little known. This prospective study focused on the effectiveness and safety of BAE-facilitated polypectomy in small bowel for young pediatric PJS. PJS patients (aged 0-14years old) with BAE (including both single-balloon and double-balloon enteroscopies) were included from 1 September 2012 to 30 April 2018. The demographic data, medical history, and details of BAE were recorded. BAE-related complications and symptom relief after BAE were evaluated and compared between the PJS patients aged 5-10years old (the younger pediatric group) and those aged 11-14years old (the older pediatric group). A total of 41 pediatric PJS patients (5-14years old) subjected to 82 BAEs were included. BAE-facilitated polypectomy was performed for 33 children (80.5%), and 242 polyps in small bowel were removed. For 10 (24.4%) patients, one or more giant polyps (maximum diameter larger than 5cm) were removed. For eight patients, no polypectomy was done as no polyps were observed (six subjects) or not suitable for BAE-facilitated polypectomy (two subjects) because of high risk of perforation. The complication rates of BAE and BAE-facilitated polypectomy were 1.2% (1/82) and 1.8% (1/55), and the symptom relief rate was 70.8% (17/24). Compared with the older pediatric group, the younger pediatric group showed no increased BAE complication rate (0.0% vs. 5.0%, p = 0.488) and a comparable rate of symptom relief after BAE therapy (80.8% vs. 55.6%, p = 0.356).Conclusion: BAE-facilitated polypectomy in young pediatric PJS is safe and effective.What is known:• Small bowel evaluation and prophetic polypectomy are important for pediatric PJS patients to avoid polyp-related intussusception, obstruction, and bleeding.• BAE polypectomy was a recommended intervention for removing small bowel polyps in adult PJS patients.What is new:• BAE-facilitated small bowel polypectomy is safe and effective for young pediatric PJS, even for those aged less than 10years old.

Utility and Safety of Balloon-Assisted Enteroscopy in Small Bowel Crohnʼs Disease: Single - Center Cohort Experience

Utility and Safety of Balloon-Assisted Enteroscopy in Small Bowel Crohnʼs Disease: Single - Center Cohort Experience

Balloon-assisted enteroscopy in portal hypertensive enteropathy.

Balloon-assisted enteroscopy (BAE) provides higher-resolution of imaging and allows both diagnosis and treatment in the small intestine. However, the role of BAE in portal hypertensive enteropathy (PHE) is not clear. The purpose of this study is to define BAE findings and its utility in patients with PHE. This study included 20 cirrhotic patients with PHE and 20 control patients, matched by age and gender, who underwent BAE. The indications were to investigate the cause of obscure gastrointestinal bleeding and to achieve a diagnosis in patients with abnormal video capsule endoscopy and/ or abnormal radiological imaging. We evaluated the diagnostic yield and safety of BAE in PHE. BAE revealed significantly abnormal small bowel mucosa including angiodysplasia-like lesions, friability, edema, erythema, and punctate hemorrhage in PHE. There was a significantly higher prevalence of small bowel angiodysplasia- like lesions (65%) in the cirrhotic patients as compared with that (10%) in the controls (p = 0.01). Among the patients with small bowel angiodysplasialike lesions (65%), seven patients (35%) exhibited a diffuse pattern, which was not found in the control group (p = 0.008). Our study has shown that small bowel angiodysplasia-like lesion, particularly, the diffuse form of the lesion, is the dominant mucosal abnormality in PHE.