Device-assisted enteroscopy: Are we ready to dismiss the spiral?

Figure 1 The two cases of motorized spiral enteroscopy esophageal entrapment during withdrawal. A: A 49-year-old female patient (body mass index 18) with familiar adenomatous polyposis and a small tubular adenoma of the jejunum resected by en bloc polypectomy. Final inspection documented linear laceration of the cervical esophagus; B: A 29-year-old female patient (body mass index 20) with Peutz–Jeghers syndrome and a major jejunal polyp (25 mm), which was resected by piecemeal mucosal resection and retrieved with a net snare; circumferential and deep laceration of the cervical esophagus was seen during withdrawal.

Figure 2 A 21-year-old female patient with juvenile polyposis associated with Osler–Weber–Rendu disease (hereditary hemorrhagic telangiectasia) and a 10-mm hamartomatous polyp of the jejunum. A: Single balloon enteroscopy was used to reach the medium jejunum; B: A tattoo with submucosal ink was placed at the maximum insertion depth; C: A few months later, the same endoscopist performed motorized spiral enteroscopy, reaching the distal jejunum: D: The polyp could be detected and easily removed with standard polypectomy. Note the different looping of the scope in the fluoroscopic view.