JLE

Hépato-Gastro & Oncologie Digestive

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Small bowel examination: the role of small bowel endoscopy Volume 20, issue 7, Septembre 2013

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Authors
Hôpital Européen Georges Pompidou, service d’hépatogastroentérologie, 20 rue Leblanc, 75015 Paris, France

Small bowel endoscopy has become a major technique in the exploration of the small intestine. It is generally performed after a preliminary examination by capsule endoscopy. Three equivalent techniques exist: the double balloon enteroscopy, the simple balloon enteroscopy and the spiral enteroscopy. The most frequent indications of small bowel endoscopy are occult gastrointestinal bleedings from small bowel angiectasia and small bowel tumors. Crohn and celiac diseases are less common indications for estimating small bowel disease activity and ruling out complications such as high grade lymphoma in celiac disease. Therapeutic small bowel endoscopy concerns mostly haemostasis of vascular lesions (angiectasia) and polypectomy. Other rare therapeutic indications concern balloon dilation of small bowel stenosis, bilio-pancreatic catheterisation after diversion surgery and extraction of foreign bodies. Small bowel endoscopy is a minimal invasive procedure with few morbidities and severe complications occur in about 1 to 3% of cases, mostly perforations or acute pancreatitis. Technical progresses are expected in coming years to allow safer and more effective small bowel examination.