Use of a double balloon enteroscope facilitates caecal intubation after incomplete colonoscopy with a standard colonoscope

BackgroundCaecal intubation is a necessary step in the complete endoscopic evaluation of the colon. Studies have estimated that experienced colonoscopists may fail to reach the caecum in up to 10% of cases.AimsTo evaluate the utility of the double balloon enteroscope used for complete examination of the colon in patients with incomplete standard colonoscopy.PatientsTwenty consecutive patients with incomplete colonoscopies within theVeterans Affairs Palo Alto Health Care System. Mean age of 66 years (S.D. ± 12 years, range 46–84), 16 men.MethodsProspective single-centre case series on the caecal intubation rate using standard double balloon enteroscope technique in patients with previous incomplete conventional colonoscopy.ResultsUse of the standard double balloon enteroscope technique permitted complete colonoscopy to be achieved in 95% of the patients (19/20). Seven patients (35%) had significant pathology beyond the extent of the prior incomplete colonoscopy. We performed endoscopic mucosal resection, polypectomy or biopsy. The mean time to reach the caecum was 28 min (S.D. ± 20 min, range 6–90 min). The sedation was similar to conventional colonoscopy. No complications occurred.ConclusionsThe double balloon enteroscope technology and technique can be used to complete examination of the colon in patients who were referred because of incomplete standard colonoscopy.