Introduction Double balloon endoscopy is considered a technique for the investigation of the small-bowel. Recently, Double balloon colonoscopy (DBC) using dedicated colonoscopes has been shown to be associated with very high rates of caecal intubation. In this study we report the DBC experience in our centre as second line endoscopic investigation in patients who failed conventional colonoscopy.
Methods Retrospective review of patients referred for DBC to our Centre from July 2009 to January 2012.
Results Twenty-three consecutive patients (12 male/11 female mean age 60.2±16 years) underwent DBC. The sedation used was midazolam/fentanyl (mean: 3.5/75 mg). 19/23 had a DBC due to previously failed colonoscopies. In four, DBC was first choice test as they had unpleasant experiences from conventional colonoscopy in the past. In 7/23 (30.4%), there was evidence of previous abdominal surgery. In 4/23 (17.4%) a fixed and/or acutely angulated sigmoid was the cause of failure. In the remaining 12 patients, significant patient discomfort was the principal cause of failure. Nine patients (39.1%) had one failed colonoscopy, six (26.1%) had two failed colonoscopies, while four (17.4%) had more than two failed colonoscopies. In 22/23 DBC (95.7%) was successful; the entire colon and terminal ileum DBC were examined in all cases. No immediate or delayed complications were recorded. Patient tolerability was very good.
Conclusion DBC is a safe and reliable method for complete colon examination and it is an important alternative technique in cases where a conventional colonoscopy has failed. Patient groups that are more likely to benefit are those with adhesions due abdominal surgery or fixed and angulated sigmoid colon. The technique is currently limited to few centers only, but the success rate and the very good patient tolerability suggest that it should be considered as an alternative in challenging cases.
Competing interests E. Alexandridis Grant/Research Support from: Fujifilm, Imotech, A. Koulaouzidis: None Declared, K. Trimble: None Declared, J. Plevris Grant/Research Support from: Fujinon, Imotech.