Main issues in push enteroscopy

Endoscopic evaluation of the small bowel has rapidly evolved over the last ten years, marking an important mile-stone in the diagnosis and treatment of small bowel diseases. Gradual progress in endoscopic techniques and development of new instruments with full therapeutic options have aided and spread the use of enteroscopy. However, some basic issues concerning its appropriate use in clinical practice remain to be soh ed This article stresses the importance of lesions missed at oesophagogastuodenoscopy in patients with obscure gastrointestinal bleeding who undergo push enteroscopy, focuses on the limits of outcome studies related to therapeutic enteroscopy, and critically reviews the clinically relevant indications to push enteroscopy.