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Intestinal Research 2007;5(1):38-44.
Published online June 30, 2007.
Endoscopic Differentiation of Small Bowel Strictures
Hwang Choi, Kyu Yong Choi, Bo In Lee, Min Kuk Kim, Hyun Jung Jung, Jeong Seon Ji, Tae Ho Kim, Jung Hwan Oh, Kang Moon Lee, Sang Woo Kim, Soo Heon Park, Hiun Suk Chae, Myung Gyu Choi, Sok Won Han, In Sik Chung
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Incheon, Korea
소장 협착의 내시경적 감별
최황, 최규용, 이보인, 김민국, 정현정, 지정선, 김태호, 오정환, 이강문, 김상우, 박수헌, 채현석, 최명규, 한석원, 정인식
가톨릭대학교 의과대학 내과학교실
The diagnosis of small bowel stricture was made by operation. Capsule endoscopy has been useful for diagnosis of small bowel diseases but has limited value in cases with stricture. Double balloon endoscopy is the useful method to visualize the entire small bowel. The aims of this study are to evaluate the feasibility of double balloon endoscopy and to differentiate the endoscopic findings in patients with small bowel stricture. Methods: Between March 2004 and February 2007, fifteen consecutive patients were referred for the evaluation of small bowel stricture. Small bowel strictures were suspected in small bowel series and CT in eleven patients. Capsule endoscopies were performed in six patients and entrapped in three patients. Double balloon endoscopy (EN-450P5/20, Fujinon, Japan) was performed with midazolam (median 5 mg, range 5-10 mg) and meperidine (median 50 mg, range 50-100 mg). All lesions except one were found within 60 minutes. One patient had been excluded because of false-positive finding of capsule endoscopy. Clinical and endoscopic findings were compared between strictures of Crohn's disease (group I, n=6) and those of other causes (group II, n=8). Results: Double balloon endoscpies were performed with good tolerance without side effect. Age, chief complaints, duration of symptom, and initial hemoglobin and serum albumin levels were not different between two groups. The proportion of male sex was higher in group I than group II (100%, 38%, respectively; p=0.031). The strictures below 0.5 cm in diameter were 83% in group I and 13% in group II (p=0.026). The arrangement of stricture in group I was more eccentric than that in group II (100%, 17%, respectively; p=0.015). The location of stricture, appearance of surrounding mucosa, associated ulcer, and ulcer margin were not different between two groups. Conclusions: Endoscopic differentiation using double balloon endoscopy can be made easily and safely in patients with small bowel stricture. The strictures of small bowel in patients with Crohn's disease were narrower and more eccentric than those in patients with other diseases. (Intest Res 2007;5:38-44)
Key Words: Small bowel stricture, Crohn disease, Double balloon endoscopy
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