Diagnostic and therapeutic possibilities of balloon-assisted enetroscopy in clinical practice

The aim. To evaluate the effectiveness of endoscopic techniques for gastrointestinal bleeding of unknown origin in the conditions of GBUZ “KKB No. 2” and to determine the most effective therapeutic tactics. Materials and methods. The basis for our study was the analysis of the results of treatment of 47 patients with suspected small intestine bleeding in the period 2018-2023 in the State Medical Institution “KKB No. 2” of the city of Krasnodar. The study group was dominated by men -25 patients (53%) compared with women - 27 patients (47%). The age of the patients ranged from 18 to 89 years. VCE was performed in 16 patients. In controversial and unconvincing cases, BAE-14 patients were performed. A comprehensive examination of VCE + BAE was performed in 17 patients. Results: The most rational method of endoscopic hemostasis in small intestine bleeding, according to our observation, is endoscopic clipping in combination with conservative therapy. Results. According to our observation, the most rational method of endoscopic hemostasis in small intestinal bleeding is endoscopic clipping in combination with conservative therapy. Conclusion. The capabilities of clinicians in the differential diagnosis of pathological conditions of the small intestine are enhanced by the availability of modern equipment in medical and preventive institutions, as well as to perform minimally invasive treatment, reducing the rehabilitation time due to the reduction of surgical trauma.

bleeding, jejunum, ileum, enteroscopy, endoscopy, capsule

1. Cruz Cuadrado C., López-Fernández J., García Plaza G., Montecino Romanini C., Hernández Hernández J. R. Adenocarcinoma of the small intestine in Crohn’s disease. Rev Esp Enferm Dig. 2021 Nov;113(11):798-799. doi: 10.17235/reed.2021.8050/2021.

2. Kashschenko V.A., Nakatis Y. A., Lodygin A. V., et al. Diagnosis and management of gastrointestinal bleeding from angiodisplastic lesions. Grekov’s Bulletin of Surgery. 2018;177(2):91-94. (In Russ.) doi: 10.24884/0042-4625-2018-177-2-91-94.@@ Кащенко В. А., Накатис Я. А., Лодыгин А. В. и соавт. Кровотечения из очагов ангиодисплазий желудочно-кишечного тракта: диагностика и лечение. Вестник хирургии. - 2018. -Т. 177, № 2. - С. 91-92.

3. Kashchenko V. A., Raspereza D. V., Akimov V. P. Videocapsular endoscopy in the diagnosis of gastrointestinal bleeding. news of surgery= Novosti Khirurgii. 2013;21(01):64-69. (in Russ.)@@ Кащенко В. А., Распереза Д. В., Акимов В. П. Видеокапсульная эндоскопия в диагностике желудочно-кишечных кровотечений // Новости хирургии. -2013. - № 1. - С. 64-69.

4. Ivanova E. V., Tikhomirova E. V., Larichev S. E., et al. Ulcers thin-intestinal anastomosis as the source of bleeding in patients with resection of the small intestine in history. Experimental and Clinical Gastroenterology. 2018;152(4): 30-36. (in Russ.)@@ Иванова Е. В., Тихомирова Е. В., Ларичев С. Е., и др. Язвы тонко-тонкокишечных анастомозов как источник кровотечения у пациентов с резекцией тонкой кишки в анамнезе. Экспериментальная и клиническая гастроэнтерология. -2018. - № 4. -С.30-36.

5. Jackson C.S., Strong R. Gastrointestinal Angiodysplasia: Diagnosis and Management. Gastrointest Endosc Clin N Am. 2017 Jan;27(1):51-62. doi: 10.1016/j.giec.2016.08.012.

6. Bree E., Rovers K. P., Stamatiou D., Souglakos J., Michelakis D., de Hingh I. H. The evolving management of small bowel adenocarcinoma. Acta Oncol. 2018 Jun;57(6):712-722. doi: 10.1080/0284186X.2018.1433321.

7. Havlichek D.H. 3rd, Kamboj A. K., Leggett C. L. A Practical Guide to the Evaluation of Small Bowel Bleeding. Mayo Clin Proc. 2022 Jan;97(1):146-153. doi: 10.1016/j.mayocp.2021.09.021.