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

摘要

Some of the greatest advances in Glendoscopy have occurred when 2 different technologies merged to form a novel device improving the quality of existing imaging or the access to pictures of the body previously unavailable. The recent development of capsule endo-scopy (CE) has enabled examination of the entire small bowel without surgical laparotomy and the usefulness of CE to diagnose small-bowel diseases has been reported. This method can demonstrate small lesions not detectable by conventional methods but cannot obtain biopsy specimens, observe lesions repeatedly, or permit EUS. Double-balloon entero-scopy (DBE) now makes all of these observations possible throughout the small bowel. EUS is rarely performed in the small bowel because of difficulties in its approach, but DBE allows investigation of the entire small bowel without surgical laparotomy. When an endoscopist performing DBE encounters a subepithe-lial nodule, stricture, or mass, there are 2 principal questions that need to be resolved. First, the physician must attempt to ascertain the etiology for the detected abnormality. Second, it is crucial to decide whether medical or surgical management is required. EUS of the upper-GI tract, the colon, and the rectum has proven helpful for making these decisions, but there is limited reported experience of the use of EUS with DBE.