44377 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple

Name of the Procedure:

Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion of Duodenum, Including Ileum; with Biopsy, Single or Multiple

Summary

Enteroscopy is a medical procedure used to examine the small intestine beyond the second portion of the duodenum, including the ileum. This specific type involves taking one or more biopsies (tissue samples) from the small intestine for further analysis.

Purpose

Enteroscopy is performed to identify and diagnose various intestinal conditions such as bleeding, inflammation, infections, tumors, and other abnormalities. The biopsy helps in diagnosing specific diseases by providing microscopic examination of tissue samples.

Indications

• Unexplained intestinal bleeding
• Chronic diarrhea
• Abdominal pain of unknown origin
• Suspected tumors or growths in the small intestine
• Malabsorption issues (e.g., Celiac disease)
• Abnormal imaging or lab results related to the small intestine

Preparation

• Patients are typically required to fast for 8-12 hours before the procedure.
• A bowel prep may be necessary to ensure the small intestine is clear of contents.
• Patients should inform their doctor about all medications and supplements they are taking.
• Blood tests or imaging studies may be required prior to the procedure.

Procedure Description

1. The patient is given a sedative or anesthesia to ensure comfort.
2. A thin, flexible tube with a camera (enteroscope) is inserted through the mouth and advanced through the esophagus, stomach, and duodenum into the small intestine.
3. The doctor examines the lining of the small intestine on a video monitor.
4. Biopsies are taken using special instruments passed through the enteroscope.
5. The tissue samples are collected for further pathological examination.
6. The enteroscope is then carefully withdrawn.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity and the number of biopsies needed.

Setting

Enteroscopy is generally performed in a hospital endoscopy suite or an outpatient clinic equipped with specialized endoscopy facilities.

Personnel

• Gastroenterologist or a specialized physician
• Nursing staff
• Anesthesiologist or nurse anesthetist (if sedation or anesthesia is used)
• Endoscopy technician

Risks and Complications

• Bleeding from biopsy sites
• Perforation of the small intestine
• Infection
• Adverse reactions to sedation or anesthesia
• Discomfort or pain post-procedure

Benefits

• Accurate diagnosis of small intestinal conditions
• Ability to obtain tissue samples for detailed analysis
• Minimally invasive compared to surgical options
• Helps in guiding effective treatment plans

Recovery

• Patients are usually monitored for a few hours post-procedure.
• It is recommended to have someone drive the patient home.
• Mild throat discomfort and bloating are common but temporary.
• Patients should follow specific dietary and activity instructions provided by their healthcare team.
• A follow-up appointment may be needed to discuss biopsy results.

Alternatives

• Capsule endoscopy: Swallowed capsule with a camera; non-invasive but limited for biopsy.
• Imaging studies: CT scans or MRIs; non-invasive but less detailed.
• Surgical biopsy: More invasive; generally used if endoscopy is not viable.

Patient Experience

• Patients may feel anxious, but sedation helps in minimizing discomfort.
• There can be transient bloating and mild throat irritation post-procedure.
• Pain management includes over-the-counter analgesics and rest.
• Most patients can resume normal activities within a day, barring any specific restrictions advised by their doctor.