Small-bowel endoscopy

Commentary: In the recent past, evaluation of the small bowel was limited to various radiographic techniques, red-blood-cell scintigraphy, angiography, and push enteroscopy. Overall, the success of these tests in identifying small-bowel lesions was variable and commonly unsatisfactory. The introduction of the wireless capsule endoscopy allowed complete visualization of the small intestine, but wireless capsule endoscopy lacks the ability to provide diagnostic sampling or therapeutic maneuvers. In this review, Dr Haluszka provides an excellent summary on double-balloon enteroscopy (DBE), the first technique to provide both complete diagnostic examination of the small bowel and a full range of therapeutic maneuvers and diagnostic sampling. Still, despite its clear advantage, DBE remains largely restricted to tertiary-referral centers. The review also presents other novel methods to evaluate the small bowel, such as the single-balloon enteroscope.

– Ronnie Fass, MD, Editor