Usefulness of oral video push enteroscopy in Crohn's disease

Background and Study Aims: Oral endoscopic examination of the small bowel is of vital importance when studying various clinical conditions. In this study we evaluate the diagnostic yield of push-type enteroscopy in patients with undiagnosed suspected clinical Crohn's disease using lower and upper endoscopy and double contrast X-ray in order to establish the diagnostic value of this instrument in the jejunum. Patients and Methods: Eight patients displaying symptoms of Crohn's disease, five adults with chronic diarrhea and abdominal pain and three children with retarded growth and weight loss associated,vith diarrhea underwent ambulatory enteroscopy using a Pentax videoenteroscope. Results: The average depth of insertion beyond the ligament of Treitz was 125 cm. Four patients (50%) were found to have macroscopic and/or microscopic lesions of Crohn's disease in the small intestine, which went unrecognized by other standard endoscopic and radiologic methods. Tolerance was good and there were no complications related to the procedure. Conclusion: Oral videoenteroscopy with biopsy is a safe and useful procedure for diagnosis of Crohn's disease in selected patients with suggestive symptoms and can be of great diagnostic value after failure of conventional endoscopic X-ray methods.