TIPS FOR DEEP INSERTION OF THE ENDOSCOPE IN DOUBLE BALLOON ENTEROSCOPY

Abstract

Balloon-assisted enteroscopy (BAE) has recently become an invaluable diagnostic and therapeutic modality for small intestinal diseases. The method of insertion of the endoscope in BAE differs from that in regular large intestinal endoscopy although many similarities exist.

Insertion of the endoscope in BAE is sometimes difficult if the patient has a history of multiple abdominal operations, a history of radiation therapy or visceral obesity, and requires some ingenuity such as appropriate scope selection, postural change, and abdominal manipulation. Caution must be taken as the complication of pancreatitis can occur with BAE.

BAE involves special insertion using an overtube, which makes it more complicated than regular upper/lower gastrointestinal endoscopy. Because of this, there are variations in intestinal tract shortening methods with a relative scope-overtube combination.

In BAE, perceiving the scope status during the examination, considering the underlying reason if the scope fails to progress, and correcting insertion methods are the most practical tips for insertion of the scope.