Clinical diagnosis and examination strategy for small intestinal diseases: analysis of 1108 cases
Objective:To retrospectively analyze the clinical manifestation and type of small intestinal diseases, and to explore how to improve the diagnostic rate of small intestinal diseases by effectively using capsule endoscopy(VCE), double-balloon enteroscopy (DBE), and computed tomoimagedata enterography (CTE).Methods:From January 2015 to June 2022, 1108 patients underwent small intestinal examination at Academy of Medical Sciences & Sichuan Provincial People's Hospital. These included 368, 361, and 379 cases who underwent VCE, DBE, and CTE, respectively.Results:The completion rate of small intestine examination by VCE was 93.75%, which was significantly different from that by DBE (P<0.01). However, both of them had a high detection rate of lesions and diagnosis rate of etiology. The diagnostic rates of inflammatory erosion, vascular malformation, vascular exposure, and lymphatic dilatation by VCE were significantly higher than those by DBE (P<0.01). The diagnostic rates of ulcer, adenocarcinoma, diverticulum, and hemangioma by DBE were significantly higher than those by VCE (P<0.01). DBE has advantages in the diagnosis of Crohn's disease and stromal tumors (P<0.05). When all the three examinations were combined, the diagnosis rate of small intestinal diseases increased to 87.01%; compared with the diagnosis rate by DBE, the difference was statistically significant (P<0.01).Conclusion:VCE, DBE, and CTE have their own advantages in detecting different diseases. Appropriate small intestine examination, application of optimized combined sequential examination strategy, suitable testing time, and good bowel preparation can improve the level of diagnosis, raise the cost performance of examination, and decrease the incidence rate of complications.
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