Push Endoscopy (cont.)
What is push endoscopy?
Push endoscopy (also referred to as push enteroscopy) is a procedure that allows diagnosis and treatment of
diseases in the upper small intestine. Push endoscopy reaches further into the
small intestine than the standard upper
gastrointestinal endoscopy (also known
as esophagogastroduodenoscopy, EGD).
Endoscopes for push endoscopy are similar
in length to colonoscopes, approximately 200cm and have working channels for
diagnostic and therapeutic procedures. After the endoscope is passed into the
duodenum, a more rigid overtube is passed over the endoscope to straighten its
path. With the overtube in place, the endoscope then can be advanced without
coiling in the stomach.
What are the advantages of push endoscopy?
Push endoscopy is a useful procedure for examining and delivering therapy
in the small intestine. For example, for patients with intermittently bleeding
angiodysplasias (clusters of weakened blood vessels) located in the small
intestine beyond the reach of a standard upper endoscope, push endoscopy can
be helpful in both diagnosing the bleeding site as well as in stopping the
bleeding.
What are the limitations of push endoscopy?
Push endoscopy has its limitations. Its reach is still limited and
cannot diagnose lesions in the distal small intestine (intestine closer to the
colon). The major risks of push endoscopy are the same as other endoscopic
procedures, bleeding and perforation of the intestine, either due to passage of
the endoscope or the accompanying therapeutic procedures. Because of the use of
an overtube, the risk of perforation probably is increased over the risks of an
endoscope alone.
Last Editorial Review: 3/21/2008
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