Comparison between capsule endoscopy and balloon enteroscopy in diagnosing small bowel diseases

Objective Tocompare capsule endoscopy (CE) with balloon enteroscopy in diagnosing small bowel diseases and describe the disease constitution of small bowel. Methods Clinical data about patients whounderwent capsule endoscopy and balloon enteroscopy fromAugust 2003 toDecember 2013 in our digestive endoscopy center, including gender, age, indication, examination finding, complication and soon, were retrospectively analyzed. The overall detection rate of small bowel diseases between capsule endoscopy and balloon enteroscopy was comparedand the spectrumof small bowel diseases was described. Results One hundredand sixty-five capsule endoscopy procedures were carriedout in 163 patients, obscure gastrointestinal bleeding was the most common indication (OGIB, 57.58%). Overall detection rate of abnormal findings in the small bowel was 72.12% by capsule endoscopy, and the detection rate of capsule endoscopy for OGIB patients was 80.00%. Five hundredand sixty-one balloon enteroscopy procedures were performedin 442 patients and OGIB was the most common indication (55.43%). Overall detection rate of abnormal findings was 64.25% by balloon enteroscopy and it was 64.90% in OGIB patients. Diagnostic yieldof capsule endoscopy for small bowel diseases was similar tothat of balloon enteroscopy (72.12% vs 64.25%, P=0.068). Subgroupanalysis in OGIB showedthat the detection rate of capsule endoscopy was higher than that of balloon enteroscopy (80.00% vs 64.90%, P=0.007). Small bowel diseases foundin patients underwent balloon enteroscopy were as follows: inflammatory diseases (39.79%), neoplasm(34.15%), vascular diseases (13.73%), diverticula (8.10%) and other gastrointestinal diseases such as lymphangiectasia and atrophy of villus (4.23%). As for capsule endoscopy, inflammatory diseases was the most common findings (42.86%), followedby vascular diseases (25.21%), neoplasm(including tumors and polyps, 21.85%), other gastrointestinal diseases (8.40%) and diverticula (1.68%). Conclusion The diagnostic yieldof capsule endoscopy for small bowel diseases is similar with balloon enteroscopy. However, the diagnostic yieldof capsule endoscopy is significantly higher when performedin patients with OGIB. Inflammatory lesions, tumors and vascular diseases are relatively common in small bowel diseases.