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      Rendimiento diagnóstico de la cápsula endoscópica y enteroscopia doble balón en pacientes con hemorragia digestiva oscura

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          Abstract

          Introducción: los métodos descritos para el estudio del intestino delgado han sido de difícil realización y baja certeza diagnóstica. La cápsula endoscópica (CE) y enteroscopia doble balón (EDB), permiten obtener beneficio para el estudio y tratamiento del paciente con hemorragia digestiva oscura. Objetivo: determinar el rendimiento diagnóstico de la CE y EDB en pacientes con hemorragia digestiva oscura. Métodos y pacientes: se evaluaron 50 pacientes con hemorragia digestiva oscura, en 24 pacientes se realizó CE y en 26 pacientes EDB. Los hallazgos de las lesiones por cápsula endoscópica M2A Given Imaging y enteroscopia doble balón fueron comparados. Resultados: como causa de sangrado se encontraron lesiones en el 56,52% de los pacientes utilizando CE y en 42,30 % de los pacientes con EDB (p= 0,04). Ambos estudios fueron bien tolerados. No se reportó ningún efecto adverso. Biopsias (n: 1), coagulación con argón plasma (n: 7), esclerosis con adrenalina (n: 1) fueron realizados al utilizar EDB. Conclusión: el rendimiento diagnóstico de la CE y EDB fue similar para detectar las lesiones causantes de hemorragia oscura. La ventaja de la EDB es la posibilidad de aplicar procedimientos endoscópicos terapéuticos.

          Translated abstract

          Introduction: The methods described for the study of the small bowel have been of difficult accomplishment and low diagnostic certainty. The Endoscopic Capsule (EC) and Double Balloon Enteroscopy (DBE), can be helpful in the study and treatment of the patient with occult digestive bleeding. Objective: To determine the diagnostic yield of EC and DBE in patients with occult digestive bleeding. Methods and patients: 50 patients with occult digestive bleeding were evaluated, in 24 patients EC was the method of choice and in 26 patients DBE. Findings by means of endoscopic capsule M2A Given Imaging and double balloon enteroscopy were compared. Results: A cause of bleeding was found in 56.52% of patients using EC and in 42, 30% of patients with DBE (p=0,04). Both studies were well tolerated. No adverse effects were reported. Biopsies (n: 1), argon plasma coagulation (n: 7), sclerosis with adrenalin (n: 1) were performed when using DBE. Conclusion: The diagnostic yield of EC and DBE was similar in detecting injuries causing occult bleeding. The advantage of DBE is the possibility of applying therapeutic endoscopic procedures.

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          Most cited references23

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          ASGE Technology Status Evaluation Report: wireless capsule endoscopy.

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            Lower gastrointestinal bleeding.

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              A new method of enteroscopy--the double-balloon method.

              The diagnosis and treatment of diseases of the small intestine have been impeded by difficult technical challenges. Traditionally, endoscopic evaluation of this organ has required open laparotomy with the surgically assisted passage of the scope through the intestine. Nonsurgical endoscopic techniques have been developed, including push enteroscopy, passage of a scope over a guide-string, and a method that depends on peristalsis to advance the instrument, but each of these is subject to severe limitations. A novel procedure has been devised, whereby an endoscope and a soft flexible overtube, each of which has an inflatable balloon attached to its distal end, are employed together. The technique is described in detail in the present article. Double-balloon enteroscopy allows visualization of the entire small intestine, to and fro examination of an area of interest, and the taking of biopsy specimens in a manner that is safer, quicker and less painful than previous techniques. It constitutes an important advance in the diagnosis and management of bleeding and other small intestinal disorders.
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                Author and article information

                Contributors
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                Journal
                gen
                Gen
                Gen
                Sociedad Venezolana de Gastroentereología (Caracas )
                0016-3503
                June 2007
                : 61
                : 2
                : 96-99
                Affiliations
                [1 ] Hospital Vargas de Caracas Venezuela
                Article
                S0016-35032007000200004
                bbf906d1-9a23-4be3-8dae-b474119801cb

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0016-3503&lng=en

                Occult bleeding,Endoscopic Capsule,Double Balloon Enteroscopy,sangramiento oscuro,cápsula endoscópica,enteroscopia doble balón

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