Çift balonlu enteroskopi: Tek merkez deneyimi

Year 2023, Volume: 22 Issue: 3, 127 - 135, 22.12.2023

Murat Erkut

https://doi.org/10.17941/agd.1338384

Abstract

Giriş ve Amaç: Çift balonlu enteroskopi ince bağırsak anormalliklerinin tanısının konulması ve girişimsel işlemlerinin yapılmasında önemli bir prosedürdür. Bu çalışmada Doğu Karadeniz Bölgesi’ndeki çift balonlu enteroskopi işlemi uygulanan hastaların değerlendirilmesi planlandı. Gereç ve Yöntem: Bu çalışmada Ağustos 2017 - Ocak 2023 tarihleri arasında; hastaların çift balonlu enteroskopi yapılma endikasyonları, demografik özellikleri, laboratuvar tetkikleri, görüntüleme yöntemleri, endoskopik bulguları, histopatolojik sonuçları, endoskopik girişimsel işlemler ve komplikasyonları retrospektif olarak değerlendirildi. Bulgular: Hastaların 30’u (%56) erkek, 24’ü (%44) kadın olup, ortanca enteroskopi yapılma yaşı 52 (17 - 84) /yıldı. En sık çift balonlu enteroskopi yapılma endikasyonları gizli gastrointestinal kanama (%28) ve aşikar gastrointestinal kanama (%22) idi. Enteroskopide en sık izlenen lezyon ülser, inflamasyon veya mukozal lezyon (%17) ve en sık konulan tanı Crohn hastalığı (%15) idi. Görüntüleme tetkikleri normal olan 10 hastanın 4’ünün (%40) endoskopi bulguları anormal idi ve bu hastalar adenokarsinom (%10), polip (%10), anjiodisplazi (%10) ve Crohn hastalığı (%10) tanıları aldı. Endoskopi bulguları normal olan, fakat görüntüleme yöntemlerinde anormallik izlenen 1 (%4) hastaya lenfoma tanısı konuldu. Çift balonlu enteroskopi yapılma endikasyonu gastrointestinal kanama olan hastalarda, sıklıkla tümöral (%11) ve vasküler lezyonlar (%11) izlendi ve bu hastaların çoğuna kanser ve anjiodisplazi tanısı konuldu. Gastrointestinal kanama dışındaki nedenler ile çift balonlu enteroskopi yapılan hastalarda ise, en sık ülser, inflamasyon veya mukozal lezyon (%33) tespit edildi ve bu hastaların çoğuna Crohn hastalığı (%26) tanısı konuldu. Sonuç: Çift balonlu enteroskopi ince bağırsak hastalıklarının tanısının konulmasında ve terapötik işlemlerin yapılmasında etkili ve güvenli bir prosedürdür. Bununla birlikte, ince bağırsak hastalığı için çift balonlu enteroskopi yanında klinik ve radyolojik bulgularda dikkate alınmalıdır.

Keywords

Çift balonlu enteroskopi, klinik, radyolojik bulgular

Double-balloon enteroscopy: The single center experience

Abstract

Background and Aims: Double-balloon enteroscopy is an important procedure for diagnosing small bowel abnormalities and performing interventional procedures. It was planned to evaluate the patients who underwent double-balloon enteroscopy in the Eastern Black Sea Region in this study. Materials and Methods: Patients who underwent double-balloon enteroscopy in our clinic between August 2017 and January 2023 were included in this study. Indications for double-balloon enteroscopy, demographic characteristics, laboratory tests, imaging methods, endoscopic findings, histopathological results, endoscopic interventional procedures and complications were evaluated retrospectively. Results: Thirty (56%) of the patients were male and 24 (44%) were female, and the median age at which enteroscopy was performed was 52 (17 - 84) /year. The most common indications for double-balloon enteroscopy were occult gastrointestinal bleeding (28%) and overt gastrointestinal bleeding (22%). The most common lesion observed in enteroscopy was ulcer, inflammation or mucosal lesion (17%) and most common diagnosis was Crohn’s disease (15%). Endoscopic findings of 4 (40%) of 10 patients with normal imaging examinations were abnormal, and these patients were diagnosed with adenocarcinoma (10%), polyp (10%), angiodysplasia (10%) and Crohn's disease (10%). Lymphoma was diagnosed in 1 (4%) patient with normal endoscopy findings but abnormal imaging methods. Tumor (11%) and vascular lesions (11%) were frequently observed in patients with gastrointestinal bleeding indication for double-balloon enteroscopy, and these patients were frequently diagnosed with cancer and angiodysplasia. In patients who underwent double-balloon enteroscopy for reasons other than gastrointestinal bleeding, the most common lesions were ulcer, inflammation or mucosal lesion (33%), and most of these patients (26%) were diagnosed with Crohn's disease. Conclusion: Double-balloon enteroscopy is an effective and safe procedure for diagnosing small bowel diseases and performing therapeutic procedures. However, clinical and radiological findings should be considered in addition to double-balloon enteroscopy for small bowel diseases.

Keywords

Double-balloon enteroscopy, clinical, radiological findings

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