Introduction: studies have examined the agreement between capsule endoscopy and double-balloon enteroscopy, with varying results. The aim of this study was to identify factors that predict the visualization of lesions in the small bowel by double-balloon enteroscopy after a positive capsule endoscopy.
Methods: a retrospective, observational and comparative study was performed that evaluated patients that underwent double-balloon enteroscopy after a positive capsule endoscopy, between January 2017 and August 2019. The data studied included demographics, indications, comorbidities and the results of capsule endoscopy and double-balloon enteroscopy, which were evaluated by multiple logistic regression.
Results: 91 patients were included (age 58 ± 16.5 years, 53 female). Sixty-two double-balloon enteroscopy (68.1 %) found the same lesions as capsule endoscopy. Predictive factors for a positive double-balloon enteroscopy were multiple lesions (OR 8.10, 1.50-43.78; p = 0.015) and < 15 days between both studies (OR 5.31, 1.19-23.66; p=0.029). In the subgroup of patients with small bowel bleeding (70 patients), the results of 46 double-balloon enteroscopies (65.7 %) agreed with the capsule endoscopy. Predictive factors in this group were multiple lesions (OR 13.51, 1.78-102.22; p = 0.012), < 15 days between both studies (OR 13.51, 1.78-102.22; p = 0.012), > 60 years of age (OR 7.45, 1.51-36.75; p = 0.014) and ulcers (OR 4.67, 1.08-20.22; p = 0.039).
Conclusions: predictive factors for a positive double-balloon enteroscopy after a positive capsule endoscopy were multiple lesions and < 15 days between both procedures. In patients with small bowel bleeding, age over 60 years and the presence of ulcers were also predictive factors.