Name of the Procedure:

Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion of Duodenum, Including Ileum; Diagnostic, with or without Collection of Specimen(s) by Brushing or Washing (separate procedure)

Summary

Small intestinal endoscopy, also known as enteroscopy, is a diagnostic procedure that involves the use of a flexible tube with a camera (endoscope) to examine the small intestine beyond the second portion of the duodenum, including the ileum. It allows the doctor to view the inside of your small intestine, take pictures, and collect tissue samples if needed.

Purpose

The procedure is used to diagnose and evaluate conditions of the small intestine such as bleeding, inflammation, tumors, or abnormal growths.

Indications

• Unexplained gastrointestinal bleeding
• Chronic diarrhea
• Abdominal pain
• Suspected Crohn's disease or other inflammatory bowel diseases
• Iron deficiency anemia with unknown cause
• Abnormal findings on imaging studies

Preparation

• Fasting: Patients are usually required to fast for 6-8 hours before the procedure.
• Medication Adjustments: Certain medications may need to be paused or adjusted. Patients should inform their doctor of all medications they're taking.
• Diagnostic Tests: Blood tests, imaging studies, or previous endoscopy reports may be reviewed beforehand.

Procedure Description

1. The patient is given sedation or general anesthesia to ensure comfort.
2. The endoscope is gently inserted through the mouth and guided down through the esophagus, stomach, duodenum, and into the ileum.
3. The camera transmits video images to a monitor, allowing the doctor to visually inspect the small intestine.
4. If abnormalities are found, the doctor may collect tissue samples using small tools attached to the endoscope.
5. In some cases, brushing or washing may be done to collect cells for further testing.
6. The endoscope is carefully withdrawn once the examination is complete.

Duration

The procedure typically takes about 30 minutes to 2 hours, depending on the complexity and findings.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center equipped with specialized endoscopy facilities.

Personnel

• Gastroenterologist or endoscopist
• Nurses
• Anesthesiologist or sedation nurse (if sedation is used)

Risks and Complications

• Common risks: Sore throat, abdominal discomfort, bloating
• Rare risks: Bleeding, infection, perforation of the intestinal wall, adverse reactions to sedation

Benefits

• Accurate diagnosis of gastrointestinal conditions
• Guided tissue sampling for further analysis
• Potential for early detection of serious conditions like tumors or inflammatory diseases

Recovery

• Post-procedure observation until the sedation wears off
• Avoid driving or operating heavy machinery for 24 hours if sedation was used
• Possible mild bloating or discomfort temporarily after the procedure
• Specific dietary instructions and follow-up appointments as advised by the doctor

Alternatives

• Capsule endoscopy: Swallowing a small, pill-sized video camera
• Radiologic imaging: CT or MRI scans
• Barium studies: X-ray imaging with a barium contrast

Patient Experience

During the procedure, the patient might feel minimal discomfort due to sedation. Afterward, there may be mild bloating or throat soreness. Pain management strategies and comfort measures will be provided as needed.