The role of double-balloon enteroscopy following capsule endoscopy in diagnosis of obscure Small intestinal diseases.

Objective: The aim of this study was to evaluate the detection rate accuracy of Double-balloon Enteroscopy (DBE) after Capsule Endoscopy (CE) in patients with suspected small bowel diseases. Methodology: From January 2009 to March 2012, sixty-two patients with obscure small bowel diseases who underwent CE followed by DBE were included in this study. Introduction of the endoscope by DBE was either orally or anally according to CE. Results: Sixty-two patients are reported. The overall detection rate of small bowel diseases using CE was 70.9% (44/62). Sixty-eight DBE procedures following capsule endoscopy were carried out, There was no significant difference (x(2)=0.6739, P > 0.05) of Positive findings between CE and CE +DBE. Furthermore, the detection rate of small bowel diseases in patients with obscure small intestinal bleeding using CE +DBE (90.9%, 30/33) was superior to that of CE (78.8%, 26/33); x(2)=1.8857, P > 0.05. Conclusions: Capsule Endoscopy (CE) can cover the whole GI tract and provide the selection of the route of Double-balloon enteroscopy (DBE). DBE can also serve as a good complementary approach after an initial imaging using CE. It can verify the findings of CE and provide therapeutic intervention. Using of CE followed by DBE is effective in the diagnosis and management of patients with obscure small bowel diseases.