Enteroscopy in children and adults with inflammatory bowel disease

Table 1 Technical characteristics of the currently available device-assisted endoscopes

Company	DAE system type	Endoscope model	Optical field of view	Optical depth of field	Endoscope distal outer diameter	Endoscope channel inner diameter	Endoscope working length	Overtube outer diameter	Image enhancement
Fujifilm Corporation (Tokyo, Japan)	DBE	EN-580T	140	2-100 mm	9, 4 mm	3, 2 mm	200 cm	13, 2 mm	FICE
	DBE	EN-580XP	140	2-100 mm	7, 5 mm	2, 2 mm	200 cm	11, 6 mm	FICE
	DBE	EI-580BT	140	2-100 mm	9, 4 mm	3, 2 mm	156 cm	13, 2 mm	FICE
Pentax Medical (Tokyo, Japan)	DBE on demand using BGE	G-EYE34-i10L/F	140	2-100 mm	11, 5 mm	3, 8 mm	170 cm	NA	i-scan OE
	DBE on demand using BGE	G-EYE38-i10L/F	140	2-100 mm	13, 2 mm	3, 8 mm	170 cm	NA	i-scan OE
	DBE on demand using BGE	G-EYE38-i10F2	140	2-100 mm	13, 2 mm	3, 8 mm	150 cm	NA	i-scan OE
Olympus (Tokyo, Japan)	SBE	SIF-Q180	140	3-100 mm	9, 2 mm	2, 8 mm	200 cm	13, 2 mm	NBI
	SBE	SIFH290S	140	3-100 mm	9, 2 mm	3, 2 mm	152 cm	13, 2 mm	NBI
	SE	SIF-Y0019 Motorized spiral overtube	140	2-100 mm	11, 3 mm	3, 2 mm	168 cm	31, 1 mm max1;18, 1 mm distal2	NBI
NaviAid, Smart Medical Systems, (Ra’anana, Israel)	BGE	No specific scope required	NA	NA	NA	NA	NA	NA	NA
Spirus Medical (Stoughton, United States)	SE	No specific scope required	NA	NA	NA	NA	NA	14, 5 mm	NA

¹Maximum outer diameter.

²Distal outer diameter. DAE: Device assisted enteroscopy; DBE: Double balloon enteroscopy; SBE: Single balloon enteroscopy; BGE: Balloon guided enterosopy; SE: Spiral enteroscopy; NA: Not applicable; NBI: Narrow band imaging; FICE: Flexible spectral imaging color enhancement; OE: Optical enhancement.

Table 2 Available studies on diagnostic yield and impact on patient management of device assisted enteroscopy in adult Crohn’s disease patients

Ref.	DAE system type	Study design	CD patients (n)		Diagnostic yield (%)		Impact on patient management (%)
			Suspected	Known	Suspected	Known	Suspected	Known
Mensink et al[36], J Gastroenterol 2009	DBE	Retrospective	0	40	60		75
Kondo et al[33], J Gastroenterol 2010	DBE	Retrospective	25	50	47		53
Möschler et al[34], Endoscopy 2011	DBE	Prospective	193		47		NA
Schulz et al[24], Dig Endosc 2014	DBE	Retrospective	16	0	69		NA
Navaneethan et al[25], Endosc Int Open 2014	SBE or DBE	Retrospective	22	43	27	53	NA	53
Christian et al[35], World J Gastrointest Endosc 2016	Retrograde SBE	Retrospective	29		41.4		17
Rahman et al[26], Gastrointest Endosc 2015	DBE	Retrospective	43	38	79	87	77	82
Tun et al[27], Eur J Gastroenterol Hepatol 2016	DBE	Retrospective	100	0	NA		45
Holleran et al[28], Scand J Gastroenterol 2018	SBE	Retrospective	13	39	39	77	69

DAE: Device-assisted enteroscopy; DBE: Double balloon enteroscopy; SBE: Single balloon enteroscopy; CD: Crohn’s disease; NA: Not applicable.

Table 3 Available study on device assisted enteroscopy in pediatric inflammatory bowel disease

Ref.	DAE system type	Study design	Patients (n)	Previous diagnostic work-up	Impact on patient management (%)	Therapeutic procedure	Complications
Di Nardo et al[29], Gastrointest Endosc 2012	SBE	Prospective	Suspected CD = 16, known CD = 14	MRI and CE	Suspected CD = 87%, known CD = 64%	Balloon dilation = 5 pts	Not reported
de Ridder et al[30], Gastrointest Endosc 2012	SBE	Prospective	Suspected CD = 14, known CD = 6	MRI and US	Suspected CD = 57%, known CD = 83%	NA	Not reported
Uchida et al[32], Pediatr Int 2012	DBE	Prospective	Suspected CD = 8, known CD = 4	Upper GI endoscopy, colonoscopy and SB-contrast study	Suspected CD = 75%, known CD = 75%	Balloon dilation = 1 pt	Not reported
Urs et al[31], J Pediatr Gastroenterol Nutr 2014	DBE	Prospective	Suspected CD = 3, known CD = 5	CE	Suspected CD = 66%, known CD = 100%	NA	Not reported
Broide et al[19], J Pediatr Gastroenterol Nutr 2020	BGE	Prospective	Suspected IBD = 15, known IBD = 16	NA	NA	NA	Not reported

DAE: Device-assisted enteroscopy; DBE: Double balloon enteroscopy; SBE: Single balloon enteroscopy; BGE: Balloon guided enterosopy; CE: Capsule endoscopy; IBD: Inflammatory bowel disease; CD: Crohn’s disease; NA: Not applicable; MRI: Magnetic resonance imaging; US: Ultrasonography; GI: Gastrointestinal; SB: Small bowel; CE: Capsule endoscopy.

Table 4 Available studies on endoscopic balloon dilation using balloon-assisted enteroscopy for small bowel stricture in adult Crohn’s disease patients

Ref.	DAE system type	Study design	CD patients (n)	Dilation diameter (mm), mean (range)	Technical success (%)	Clinical efficacy (%)	Dilatations (n), mean per patient (range)	Perforation (%)	Observation period (mo), mean (range)	Symptom recurrence (%)
Fukumoto et al[37], Gastrointest Endosc 2007	DBE	Retrospective	23	NA	NA	74	35, (1.52; 1-6)	0	12, (1-40)	26
Pohl et al[38], Eur J Gastroenterol Hepatol 2007	Push enteroscopy	NA	10	17, (12-20)	80	60	15, (1.5; 1-3)	0	10, (4-16)	40
Ohmiyaet al[39], Gastrointest Endosc 2009	DBE	Retrospective	16	NA, (8-20)	96	69	NA	0	16, (2-43)	31
Despottet al[40], Gastrointest Endosc 2009	DBE	Prospective	11	15.4, (12-20)	73	73	18, (2; 1-3)	9	20.5, (2-41)	25
Hirai et al[41], Dig Endosc 2010	DBE	Retrospective	25	NA, (12-18)	72	72	55, (2.2; 1-4)	0	11, (6-29)	22
Kondo et al[33], J Gastroenterol 2010	DBE	Retrospective	8	NA	100	87.5	18, 1.5 (1-2)	0	NA	NA
Gill et al[42], Ther Adv Gastroenterol 2014	DBE	Retrospective	10	13.5, (10-16.5)	80	70	17, (1.8; 1-4)	20	NA	14
Hirai et al[43], Dig Endosc 2014	DBE	Retrospective	65	NA, (12-18)	80	80	NA	1.5	NA	48
Navaneethan et al[25], Endosc Int Open 2014	BAE (SBE/DBE)	Retrospective	6	NA	100	100	7, (1.16; 1-2)	16	NA	NA
Sunada et al[44], Inflamm Bowel Dis 2016	DBE	Retrospective	85	12.4, (8–20)	NA	87	321, (3.8; 1–14)	5	41.9, (0–141)	78.5
Holleran et al[28], Scand J Gastroenterol 2018	SBE	Retrospective	13	13, (12-15)	100	80	14, (1; 1-2)	0	8, (2-16)	23
Hirai et al[45], Journal of Crohn's and Colitis 2018	SBE and DBE	Prospective	95	15, (8-20)	94	70	90, (1; 1-2)	0	24, (NA)	NA

BAE: Balloon-assisted enteroscopy; DBE: Double balloon enteroscopy; SBE: Single balloon enteroscopy; SB: Small bowel; CD: Crohn’s disease; NA: Not available or not applicable; DAE: Device assisted enteroscopy.