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The benefit of double-balloon enteroscopy combined with abdominal contrast-enhanced CT examination for diagnosing small-bowel obstruction

Intérêt d’une entéroscopie à double ballon associée à une tomodensitométrie abdominale avec contraste dans le diagnostic des obstacles du grêle

  • Original Article / Article Original
  • Published:
Acta Endoscopica

Abstract

Objective

To investigate the clinical value of double-balloon enteroscopy (DBE) combined with abdominal contrast-enhanced CT examination in diagnosing smallbowel obstruction.

Methods

Ninety-four patients with confirmed small-bowel obstruction admitted to our hospital from January 2007 to October 2012 were enrolled in the retrospective study. DBE and abdominal contrast-enhanced CT examination were performed. Clinical data and information were collected and analyzed.

Results

One hundred and four DBE, including forty-four antegrade approaches, forty-eight retrograde approaches, and twelve combinations of both routes, were performed in ninety-four patients. Eighty-six lesions were detected. The detection rate of abdominal contrast-enhanced CT, DBE, and DBE combined with abdominal contrast-enhanced CT were 65.9%, 95.3%, and 98.8%, respectively. The sensitivity of the three methods in diagnosing tumor small-bowel obstruction were 84.2%, 94.7%, and 97.4%, and in nontumor small-bowel obstruction were 63.0%, 76.1%, and 97.8%, respectively. The coincident rate of the three methods’ diagnosis with surgical and pathologic diagnosis was 72.1%, 82.5%, and 93.0%, respectively. There was no sufficient difference between DBE alone and abdominal contrastenhanced CT in the sensitivity of diagnosing tumor and non-tumor small-bowel obstruction (χ2 = 2.235, P = 0.135; χ2 = 1.848, P = 0.174). However, there were significant differences between DBE and DBE combined with abdominal contrast-enhanced CT in the sensitivity of diagnosing nontumor small-bowel obstruction and the coincident rate with surgical and pathologic diagnosis (χ2 = 9.583, P = 0.002; χ2 = 4.394, P = 0.036).

Conclusion

DBE combined with abdominal contrastenhanced CT is very valuable in diagnosing small-bowel obstruction and can provide suitable treatment.

Résumé

Objectif

Étudier la valeur clinique de l’entéroscopie à double ballon (EDB) associée à une tomodensitométrie abdominale avec contraste dans le diagnostic d’une occlusion de l’intestin grêle.

Méthodes

Quatre-vingt-quatorze patients atteints d’une occlusion de l’intestin grêle admis dans notre hôpital de janvier 2007 à octobre 2012 ont participé à l’étude rétrospective. Des EDB et des tomodensitométries abdominales avec contraste ont été réalisées. Les données et informations cliniques ont été recueillies et analysées.

Résultats

Cent quatre EDB, comprenant 44 approches antérogrades, 48 approches rétrogrades et 12 associations des deux méthodes, ont été réalisées chez 94 patients. Quatrevingt-six lésions ont été constatées. Les taux de détection des tomodensitométries abdominales avec contraste, des EDB et des EDB associées à des tomodensitométries abdominales avec contraste étaient respectivement de 65,9 %, 95,3 % et 98,8 %. La sensibilité des trois méthodes permettant de diagnostiquer les occlusions de l’intestin grêle tumorales était de 84,2 %, 94,7 % et 97,4 % respectivement et, dans les cas d’occlusions de l’intestin grêle non tumorales, de 63,0 %, 76,1 % et 97,8 % respectivement. Le taux de concordance du diagnostic des trois méthodes avec le diagnostic chirurgical et pathologique était de 72,1 %, 82,5 % et 93,0 % respectivement. Aucune différence suffisante n’a été constatée entre la sensibilité de l’EDB seule et la tomodensitométrie abdominale avec contraste dans le diagnostic des occlusions de l’intestin grêle tumorales et non tumorales (χ2 = 2,235, p = 0,135; χ2 = 1,848, p = 0,174). Cependant, des différences importantes ont été constatées entre l’EDB et l’EDB associée à la tomodensitométrie abdominale avec contraste en ce qui concerne la sensibilité lors du diagnostic d’occlusions de l’intestin grêle non tumorales et le taux de concordance avec les diagnostics chirurgicaux et pathologiques (χ2 = 9,583, p = 0,002; χ2 = 4,394, p = 0,036).

Conclusion

L’EDB associée à la tomodensitométrie abdominale avec contraste est extrêmement utile pour diagnostiquer les occlusions de l’intestin grêle et peut déboucher sur un traitement approprié.

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Authors and Affiliations

  1. Department of Gastroenterology, Affiliated Yantai Yu Huang Ding Hospital of Qingdao University Medical School, Yantai, 264000, P.R. China

    N. Xu, X. -L. Cao, L. Wang, X. -T. Li & L. -Y. Huang

  2. Department of Diagnosis, Binzhou Medical University, Binzhou, P. R. China

    N. -E. Li

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  1. N. Xu
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  2. N. -E. Li
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  3. X. -L. Cao
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  4. L. Wang
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  5. X. -T. Li
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  6. L. -Y. Huang
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Correspondence to L. -Y. Huang.

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Xu, N., Li, N.E., Cao, X.L. et al. The benefit of double-balloon enteroscopy combined with abdominal contrast-enhanced CT examination for diagnosing small-bowel obstruction. Acta Endosc 43, 242–247 (2013). https://doi.org/10.1007/s10190-013-0342-4

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  • DOI: https://doi.org/10.1007/s10190-013-0342-4

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