⁎4747 Diagnostic yield of push-enterostomy in nonbleeding intestinal disorders.

The main indication for push-enteroscopy is obscure digestive bleeding. However, endoscopic investigation of the small bowel is also used in other intestinal disorders. Aim of the study : to define the indications and the diagnostic yield of push-enteroscopy in patients with non-bleeding intestinal disorders. Methods : all the enteroscopies, that were performed in our institution from January 1995 to October 1999 were reviewed. The Olympus push-enteroscopes (SIF-100 or 140) were used, on sedation (93%) or general anesthesia. Indications were divided in 4 groups : unexplained malabsorption (I), undefined radiologic lesions (II), unexplained abdominal pain (III) and follow-up of chronic diseases (i.e. coeliac diseases, lymphoma, familial polyposis, Crohn's disease) (IV). These results were considered to be positive, allowing a definitive diagnosis ; helpfull, permitting to rule out some diseases ; or negative. Results : 64 out of 445 (14%) of push-enteroscopies were performed in 59 patients (29 m/30 f ; mean age 47 y). In conclusion : in non-bleeding disorders, the diagnostic yield of pushenteroscopy was positive in 39%, helpfull in 32% and negative in 29%, respectively. In these indications, push-enteroscopy must be used in well selected patients. The highest positive yield was observed in the follow-up of patients with chronic intestinal disorders.