Balloon Assisted Enteroscopy Is an Emerging Tool in the Management of Crohnʼs Disease
Bibliographic record
Abstract
Introduction: Seventy percent of CD patients suffer from small bowel involvement and up to 30% have isolated small bowel disease. Double and Single Balloon Enteroscopy (DBE and SBE, respectively) allow for improved visualization and for therapeutic intervention. This study aims to investigate the efficacy and safety of both procedures - Balloon Assisted Enteroscopy (BAE) - in patients with known or suspected small-bowel CD. Methods: A retrospective chart review was undertaken to examine all patients with small-bowel CD who underwent BAE over the last 4 years. Patient demographics (age at operation, duration of disease), disease characteristics (location, complication), surgical history, previous imaging (CTE, MRE, SBFT, VCE), procedure characteristics (indications, findings, therapy, safety, outcomes), and stricture dilation data were all recorded. Results: 56 BAEs (45 Anal, 10 oral, 1 stomatal) were performed on 32 patients (19 Male). The mean age at BAE was 46.5 years. 45 (83%) of procedures were on patients with known CD, 9 (17%) were on patients to establish a new diagnosis. 27 (84%) of patients had ileal CD, 2 (6%) had jejunal, and 3 (9%) had both. 19 (59%) of patients had at least one previous bowel resection. CTE was the most frequently used imaging modality with 26 (82%) patients having had a previous scan; 20 (77%) showed positive findings for CD, 6 (30%) showed negative findings and did not agree with the BAE findings. Small bowel strictures were found in 21 (65%) patients on BAE; 14 (44%) paitents underwent 22 BAE procedures and 48 balloon-assisted stricture dilations were perofrmed. The average diameter of dilation was 16 mm; 9 strictures were considered non-traversible. Complications occured in 2 (4%) BAE procedures; 1 patient developed acute pancreatitis, the other had minor bleeding post-dilation. There were no perforations or deaths. Conclusion: Balloon assisted enteroscopy is a safe and effective procedure for visualization and treatment of small bowel CD and is likely under-utilized as an endoscopic tool. BAE provides the ability to directly visualize small bowel CD beyond simple ileal intubation. Stricture dilation via BAE is a safe procedure that can alleviate obstructive symptoms for both patients who have had previous resections or those with primary stenosis. The combination of therapeutic intervention and direct and extensive mucosal visualization makes BAE the optimal modality for diagnosis and treatment of small bowel CD.Table 1: Demographics for Patients with Known or Query Crohn's undergoing Balloon Assisted EnteroscopyTable 144b: Comparison of Imaging Modalities to Balloon Assisted Enteroscopy findings in Patients with Known or Query Crohn's Disease
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".