Comparison of detectability of small-bowel lesions between capsule endoscopy and double-balloon endoscopy for patients with suspected small-bowel disease.

BACKGROUND: There are many reports of the usefulness of capsule endoscopy (CE) or double-balloon endoscopy (DBE) for the detection of small-bowel disease. However, there are few reports that compared CE and DBE.

OBJECTIVE: To determine whether CE or DBE better detects small-bowel lesions in patients with suspected small-bowel disease.

DESIGN: A prospective single-center study.

SETTING: Department of Endoscopy, Hiroshima University Hospital.

MAIN OUTCOME MEASUREMENTS: Rates of CE and DBE detection of small-bowel lesions.

PATIENTS: Seventy-six consecutive patients (47 men, 29 women; mean age 56.0 years) who underwent both CE and DBE.

METHODS: CE was performed before DBE. DBEs were performed within 1 week, by both retrograde and antegrade approaches so that the entire small bowel could be examined, if possible.

RESULTS: Small-bowel lesions were detected by CE in 42 patients (55.3%) and by DBE in 46 patients (60.5%). The difference was not significant (P = .45). Total enteroscopy was achieved by both examinations in 35 patients, and small-bowel lesions were detected by both examinations in 21 of the 35 patients (60.0%). Agreement between results of the 2 examinations was good (kappa = 0.76).

LIMITATION: The main indication for examinations was not the same.

CONCLUSIONS: CE and DBE are nearly equal in their ability to detect small-bowel lesions if the entire small bowel is examined.