小肠镜

定义

小肠镜 is a procedure used to examine the small intestine (small bowel).

选择的名字

Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy

如何执行测试

细而柔软的管子(内窥镜) is inserted through the mouth and into the upper gastrointestinal tract. During a double-balloon enteroscopy, balloons attached to the 内窥镜 can be inflated to allow the doctor to view a section of the small intestine.

在一个 结肠镜检查, a flexible tube is inserted through your rectum and colon. The tube can most often reach into the end part of the small intestine (ileum). 胶囊内窥镜 is done with a disposable capsule that you swallow.

Tissue samples removed during enteroscopy are sent to the lab for examination. (Biopsies cannot be taken with a capsule endoscopy.)

How to Prepare for the Test

Do not take products containing aspirin for 1 week before the procedure. Tell your health care provider if you take blood thinners such as warfarin (Coumadin), 氯吡格雷, or apixaban (Eliquis) because these may interfere with the test. Do not stop taking any medicine unless told to do so by your provider.

Do not eat any solid foods or milk products after midnight the day of your procedure. You may have clear liquids until 4 hours before your exam.

You must sign a consent form.

考试的感觉如何

You will be given calming and sedating medicine for the procedure and will not feel any discomfort. You may have some bloating or cramping when you wake up. This is from air that is pumped into the abdomen to expand the area during the procedure.

A capsule endoscopy causes no discomfort.

为什么要进行测试

This test is most often performed to help diagnose diseases of the small intestines. It may be done if you have:

• x线异常结果
• Tumors in the small intestines
• 不明原因的腹泻
• Unexplained gastrointestinal bleeding

正常的结果

在一个正常的测试结果, the provider will not find sources of bleeding in the small bowel, and will not find any tumors or other abnormal tissue.

异常结果意味着什么

迹象可能包括:

• Abnormalities of the tissue lining the small intestine (mucosa) or the tiny, finger-like projections on the surface of the small intestine (villi)
• Abnormal lengthening of blood vessels (angioectasis) in the intestinal lining
• Immune cells called PAS-positive macrophages
• 息肉 或癌症
• 放射性肠炎
• 肿胀或增大 淋巴结 或者淋巴管
• 溃疡

Changes found on enteroscopy may be signs of disorders and conditions, including:

• 淀粉样变
• 乳糜泻
• 克罗恩病
• 叶酸 or 维生素B12 缺乏
• 梨形鞭毛虫病
• 传染性 肠胃炎
• 淋巴管扩张
• 淋巴瘤
• Small intestinal angiectasia
• 小肠癌
  
• 热带口炎性腹泻
• 惠普尔疾病

风险

Complications are rare but may include:

• Excessive bleeding from the biopsy site
• Hole in the bowel (bowel perforation)
• Infection of the biopsy site leading to 菌血症
• 呕吐，接着是 愿望 进入肺部
• The capsule 内窥镜 can cause a blockage in a narrowed intestine with symptoms of abdominal pain and bloating
  
  

注意事项

Factors that prohibit use of this test may include:

• Uncooperative or confused person
• Untreated blood clotting (coagulation) disorders
• Use of aspirin or other medicines that prevent the blood from clotting normally (anticoagulants)

The greatest risk is bleeding. 症状包括:

• 腹部疼痛
• 大便带血
• 吐血

参考文献

马金考斯基P，菲切拉A. Management of lower gastrointestinal bleeding. In: Cameron AM, Cameron JL, eds. 目前的外科治疗. 13日艾德. Philadelphia, PA: Elsevier; 2020:341-347.

罗哈斯I，巴斯B. 胶囊内窥镜 and small bowel enteroscopy. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6日艾德. Philadelphia, PA: Elsevier; 2021:chap 63.

Sugumar A, Vargo JJ. Preparation for and complications of gastrointestinal endoscopy. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11日艾德. Philadelphia, PA: Elsevier ; 2021:chap 42.

Waterman M, Zurad EG, Gralnek IM. 视频胶囊内窥镜. 见:福勒GC编. Pfenninger and Fowler's Procedures for 初级护理. 第四版. Philadelphia, PA: Elsevier; 2020:chap 93.