Push Enteroscopy – First-year Experience
Vašíček M., Frič P., Zavoral M.
2. interní oddělení Ústřední vojenské nemocnice, Praha, ředitel plk. doc. MUDr.M. Bartoš, CSc. Subkatedra gastroenterologie IPVZ, Praha, ředitel MUDr. A. Malina |
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Summary:
Push enteroscopy enables diagnostic and therapeutic endoscopy
of aboral duodenum and proximal jejunum. During
the first year of introducing this method 92 examinations
were performed in 89 subjects with use of push
enteroscope SIF 140 Olympus. The most frequent
indications were overt or occult bleeding (with or without
anaemia) without detectable lesion on previous endoscopy
of the upper digestive tract and colonoscopy or enteroclysis.
Other indications included: celiac sprue, suspected
primary or secondary tumour of small intestine, and
Crohn enteritis. Endoscopic changes were observed in one
third of subjects examined. The ratio of subjects with
individual indications and positive endoscopic findings
amounted to: 25/4 in bleeding, 27/10 in celiac disease
(histologically verified), 19/9 in primary and 3/3 in
secondary tumour, 14/4 in Crohn enteritis, and 1/1 in
another finding. A therapeutic procedure was performed
in 6 probands: argon plasma coagulation of angiodysplasias
in 4 persons and endoscopic polypectomy in two other
subjects. Push enteroscopy is technically more difficult
than endoscopy of the upper and lower part of digestive
tract and requires a longer time-period for acquainting
sufficient skill and experience. Its results may be increased
by combination with the use of retrograde ileoscopy
and intraoperative enteroscopy. Prospective controlled
studies of push enteroscopy targeted on individual indications
are urgently needed.
Key words:
push enteroscopy, first-year experience, indications,
small-intestinal diseases
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