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double-balloon endoscopy in the diagnosis and management of GI tract diseases:Methodology,indications,safety,and clinical impact

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World Journal of Gastroenterology 2006年第47期12卷 7654-7659页

作者： Kazuya Akahoshi Masaru Kubokawa Masahiro Matsumoto Shingo Endo Yasuaki Motomura Jiro Ouchi Mitsuhide Kimura Atsuhiko Murata Michiaki Murayama Department of Gastroenterology Aso Iizuka Hospital Iizuka 820-8505 Japan

AIM： To prospectively evaluate the indications, methodology, safety, and clinical impact of double-balloon endoscopy. METHODS： A total of 60 patients with suspected or documented small- or large-bowel diseases were investigated by double balloon endoscopy. A total of 103 procedures were performed （42 from the oral route, 60 from the anal route, and 1 from the stoma route）. The main outcome measurements were the time of insertion and the entire examination, complications, diagnostic yields, and the ability to successfully perform treatment. RESULTS： Observation of the entire small intestine was possible in 10 （40%） of 25 patients with total enteroscopy. The median insertion time was 122 min （range, 74-199 min）. Observation of the entire colon was possible in 13 （93%） of 14 patients at＂cer failure of total colonoscopy using a conventional colonoscope. Small-intestine abnormalities were found in 20 （43%） of 46 patients with indications of suspected or documented small bowel diseases, obscure GI tract bleeding, or a history of ileus. Endoscopic procedures including tattooing （n = 33）, bite biopsy （n = 17）, radiographic examination （n = 7）, EUS （n = 5）, hemostasis （n = 1）, polypectomy （n = 5）, balloon dilatation （n = 1）, endoscopic mucosal resection （n = 1） and lithotripsy （n = 1） were all successfully performed. No relevant technical problems or severe complications were encountered. CONCLUSION： double balloon endoscopy is a feasible technique that allows adequate small and large bowel examination and potentially various endoscopic procedures of small-intestinal lesions. It is safe, useful, and also provides a high clinical impact.

关键词： double-balloon endoscopy GI tract disease Endoscopic therapy

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Non-steroidal anti-inflammatory drug-induced small bowel injuries identified by double-balloon endoscopy

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World Journal of Gastroenterology 2005年第31期11卷 4861-4864页

作者： Yoshikazu Hayashi Hironori Yamamoto Hiroto Kita Keijiro Sunada Hiroyuki Sato Tomonori Yano Michiko Iwamoto Yutaka Sekine Tomohiko Miyata Akiko Kuno Takaaki Iwaki Yoshiyuki Kawamura Hironari Ajibe Kenichi Ido Kentaro Sugano Department of Internal Medicine

AIM： To clarify clinical features of the NSAID-induced sma bowel lesions using a new method of endoscopy. METHODS： This is a retrospective study and we analyzed seven patients with small bowel lesions while taking NSAIDs among 61 patients who had undergone doubleballoon endoscopy because of gastro-intestinal bleeding or anemia between September 2000 and March 2004, at .lichi Medical School Hospital in Japan. Neither conventional EGD nor colonoscopy revealed any lesions of potential bleeding sources including ulcerations. double-balloon endoscopy was carried out from oral approach in three patients, from anal approach in three patients, and from both approaches in one patient. RESULTS： Ulcers or erosions were observed in the ileum in six patients and in the jejunum in one patient, respectively. The ulcers were multiple in all the patients with different features from tiny punched out ulcers to deep ulcerations with oozing hemorrhage or scar. All the patients recovered uneventfully and had full resolution of symptoms after suspension of the drug. CONCLUSION： NSAIDs can induce injuries in the small bowel even in patients without any lesions in both the stomach and colon.

关键词： double-balloon endoscopy NSAIDS-inducedsmall bowel injuries

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Accuracy of carbon dioxide insufflation for endoscopic retrograde cholangiopancreatography using double-balloon endoscopy

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World Journal of Gastroenterology 2020年第42期26卷 6669-6678页

作者： Yoshiki Niwa Masanao Nakamura Hiroki Kawashima Takeshi Yamamura Keiko Maeda Tsunaki Sawada Yasuyuki Mizutani Eri Ishikawa Takuya Ishikawa Naomi Kakushima Kazuhiro Furukawa Eizaburo Ohno Takashi Honda Masatoshi Ishigami Mitsuhiro Fujishiro Department of Gastroenterology and Hepatology Nagoya University Graduate School of MedicineNagoya 466-8560Japan Department of endoscopy Nagoya University HospitalNagoya 466-8560Japan

BACKGROUND Retrograde cholangiopancreatography using double-balloon endoscopic retrograde cholangiography(DBERC)is a valuable technique to treat biliary stone and jejunobiliary anastomotic stenosis in patients with altered gastrointestinal *** accurate selection of the route at the anastomosis branch is one of the most important factors in reaching the target in a timely *** To determine the accuracy of carbon dioxide insufflation enterography(CDE)at the branch for selecting the correct route during *** We enrolled 52 consecutive patients scheduled for DBERC at our institution from June 2015 to November *** selection via two methods(visual observation and CDE)was performed in each *** determined the correct rate of route selection using *** Thirty-three patients had a jejunojejunal anastomosis and 19 patients had a gastrojejunal *** therapeutic target region was reached in 50 *** mean procedure times from the teeth to the target(total insertion time),from the teeth to the branch,and from the branch to the target,and the mean total examination time were 15.2,5.0,8.2,and 60.3 min,*** rate of correct route selection using visual observation and CDE were 36/52(69.2%)and 48/52(92.3%),respectively(P=0.002).The rate of correct route selection using CDE in patients with a jejunojejunal anastomosis was 29/33(87.8%),and the rate in patients with a gastrojejunal anastomosis was 19/19(100%).CONCLUSION CDE is helpful in selecting the route at the branch in the anastomosis for more timely access to the target in patients with altered gastrointestinal anatomy undergoing DBERC.

关键词： Retrograde cholangiopancreatography double-balloon endoscopy Carbon dioxide insufflation Anastomosis Accuracy Prospective study

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Imaging of the small bowel in Crohn's disease: A review of old and new techniques

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World Journal of Gastroenterology 2007年第24期13卷 3279-3287页

作者： Simone Saibeni Emanuele Rondonotti Andrea Iozzelli Luisa Spina Gian Eugenio Tontini Flaminia Cavallaro Camilla Ciscato Roberto de Franchis Francesco Sardanelli Maurizio Vecchi Gastroenterology and Gastrointestinal endoscopy Service IRCCS Fondazione Ospedale Maggiore Policlinico Mangiagalli and Regina Elena Milan Italy Gastroenterology and Gastrointestinal Endoscopy Unit IRCCS Policlinico San Donato University of Milan School of Medicine Milan Italy Radiology Unit IRCCS Policlinico San Donato San Donato Milanese University of Milan School of Medicine Milan Italy Departments of Medical and Surgical Sciences University of Milan School of Medicine Milan Italy Gastroenterology and Gastrointestinal endoscopy Unit University of Milan School of Medicine Milan Italy Gastroenterology and Gastrointestinal Endoscopy Unit IRCCS Policlinico San Donato University of Milan School of Medicine Milan Italy

The investigation of small bowel morphology is often mandatory in many patients with Crohn's disease. Traditional radiological techniques (small bowel enteroclysis and small bowel follow-through) have long been the only suitable methods for this purpose. In recent years, several alternative imaging techniques have been proposed. To review the most recent advances in imaging studies of the small bowel, with particular reference to their possible application in Crohn's disease, we conducted a complete review of the most important studies in which traditional and newer imaging methods were performed and compared in patients with Crohn's disease. Several radiological and endoscopic techniques are now available for the study of the small bowel; each of them is characterized by a distinct profile of favourable and unfavourable features. In some cases, they may also be used as complementary rather than alternative techniques. In everyday practice, the choice of the technique to be used stands upon its availability and a careful evaluation of diagnostic accuracy, clinical usefulness, safety and cost. The recent development ofinnovative imaging techniques has opened a new and exciting area in the exploration of the small bowel in Crohn's disease patients.

关键词： Crohn's disease Small bowel Imaging techniques Ultrasonography Magnetic resonance Computed tomography Video-capsule endoscopy double-balloon endoscopy

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Partial intestinal obstruction secondary to multiple lipomas within jejunal duplication cyst: A case report

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World Journal of Gastroenterology 2010年第17期16卷 2190-2192页

作者： Wan, Xin-Yue Deng, Tao Luo, He-Sheng Wuhan Univ Dept Gastroenterol Renmin Hosp Wuhan 430060 Hubei Province Peoples R China

Lipoma within jejunal duplication presenting as abdominal bloating and partial intestinal obstruction is an exceptional clinical *** report a case of 68-year-old man complaining of abdominal bloating for 10 d due to multiple lipomas arising from jejunal duplication *** a few cases of a single lipoma within a Meckel’s diverticulum giving rise to this clinical scenario have been reported in the English language ***,no case of multiple lipomas within jejunal duplication cysts has been *** present a case in which doubleballoon endoscopy revealed a small intestinal structure changed into Meckel’s diverticulum-like cavities containing several *** case highlights intestinal lipoma as an uncommon cause of adult intussusceptions,which should be included in the differential diagnosis of small intestinal obstruction and appropriate examinations should be chosen.

关键词： Duplication cyst Lipoma double-balloon endoscopy Jejunum Intestinal obstruction

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Outcome of patients who have undergone total enteroscopy for obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2012年第7期18卷 666-672页

作者： Takayoshi Shishido Shiro Oka Shinji Tanaka Hiroki Imagawa Yoshito Takemura Shigeto Yoshida Kazuaki Chayama Department of Gastroenterology Hiroshima UniversityHiroshima 734-8551Japan Department of endoscopy Hiroshima University HospitalHiroshima 734-8551Japan

AIM： To assess the diagnostic success and outcome among patients with obscure gastrointestinal bleeding who underwent total enteroscopy with double-balloon endoscopy.

关键词： double-balloon endoscopy Small bowel Obscure gastrointestinal bleeding Total enteroscopy Outcome

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Clinical impact of multidetector computed tomography before double-balloon enteroscopy for obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2012年第7期18卷 692-697页

作者： Hsu-Heng Yen Yang-Yuan Chen Chia-Wei Yang Chi-Kuang Liu Maw-Soan Soon Departmentof Gastroenterology Endoscopy Center Changhua ChristianHospital 500 Changhua Taiwan China Department of Gastroenterology China Medi-cal University Hospital 40402 Taichung Taiwan China Department of Radiology Changhua ChristianHospital 500 Changhua Taiwan China

AIM： To evaluate the clinical impact of multidetector computed tomography （MDCT） before double-balloon endoscopy （DBE） for patients with obscure gastrointestinal bleeding （OGIB）.

关键词： Multidetector computed tomography Cap-sule endoscopy double-balloon endoscopy Obscuregastrointestinal bleeding

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Eosinophilic enteritis requiring differentiation from chronic enteropathy associated with SLCO2A1 gene:A case report

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World Journal of Gastroenterology 2023年第11期29卷 1757-1764页

作者： Kantaro Kimura Keisuke Jimbo Nobuyasu Arai Masamichi Sato Mitsuyoshi Suzuki Takahiro Kudo Tomonori Yano Toshiaki Shimizu Department of Pediatrics Juntendo University Faculty of MedicineTokyo 113-8421Japan Department of Medicine Jichi Medical UniversityTochigi 329-0498Japan

BACKGROUND Eosinophilic gastrointestinal disease(EGID)is a disorder characterized by infiltration of eosinophils causing mucosal damage and dysfunction of the gastrointestinal *** endoscopic findings of eosinophilic enteritis(EoN),an EGID variant,are nonspecific and occasionally difficult to *** contrast,chronic enteropathy associated with SLCO2A1(CEAS)is a chronic persistent small intestinal disorder characterized by endoscopic findings such as multiple oblique and circular *** SUMMARY We report the case of a 10-year-old boy who had suffered abdominal pain and fatigue for the preceding 6 *** was referred to our institute for investigation of suspected gastrointestinal bleeding because of severe anemia with hypoproteinemia and positive fecal human *** upper and lower gastrointestinal endoscopic findings were normal;however,double-balloon small bowel endoscopy showed multiple oblique and circular ulcers with discrete margins and mild constriction of the intestinal lumen in the *** findings were highly consistent with CEAS,but urine prostaglandin metabolites were within normal limits,and no previously reported mutations in the SLCO2A1 gene were *** evaluation demonstrated moderate to severe eosinophilic infiltration localized to the small intestine suggesting a diagnosis of *** remission was maintained with montelukast and a partial elemental diet,but emergent surgery for bowel obstruction due to small intestinal stenosis was performed two years after the initial *** EoN should be considered in the differential diagnosis of CEAS-like small intestinal ulcerative lesions and normal urinary prostaglandin metabolite levels.

关键词： Anemia Chronic enteropathy associated with SLCO2A1 double-balloon endoscopy Eosinophilic gastrointestinal disease Hypoproteinemia Case report

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