Exploration morphologique de l’intestin grêle: quels examens pour quelles indications ?

Acta Endoscopica (Impact Factor: 0.16). 06/2009; 39(3):201-205. DOI: 10.1007/s10190-009-0036-9


The main indication of DBE is obscure gastrointestinal bleeding (OGIB). The main cause of obscure gastrointestinal bleeding is vascular lesion or angiodysplasia. Capsule endoscopy (CE) is the first examination of the small bowel in the case of OGIB. It must be done as early as possible when overt bleeding (after upper gastrointestinal endoscopy and colonoscopy), and present the best diagnostic yield in comparison with radiological techniques and other endoscopic techniques. Double balloon enteroscopy and similar techniques (single balloon and spiral enteroscopy) allow for histological confirmation and endoscopic treatment (argon plasma coagulation, polypectomy) of small intestine lesions detected by CE or radiological examination. Computed tomography enteroclysis is the best radiological examination for the diagnosis of enteropathy (Crohn’s disease or celiac disease with complications) or the diagnosis of tumours and for monitoring polyposis. Magnetic resonance imaging (MRI) of the small intestine, without radiation, could supplant the scanner in a near future.