A new double-balloon enteroscopy technique was described in 2 dogs. With this push and pull technique, an endoscope is advanced through the intestine by being held alternately by a balloon at the tip of the endoscope and a balloon on the tip of an overtube. Both oral and anal approaches were used in the study. The oral approach was completed in 2 hours and 10 minutes and involved 26 advancing maneuvers to an estimated total depth of 4.95 m. The anal approach required 15 minutes, with an estimated depth of insertion of 95 cm, and was completed with 4 advancing movements. No complications were noted in either dog. The technique was not difficult to perform, and allowed safe enteroscopy of the entire small intestine.

COMMENTARY: While endoscopy has become an increasingly common method for diagnosis and treatment of gastrointestinal disorders, the midregion of the small intestine has been left relatively neglected because of the difficulty in accessing this area. The technique described here has been safely used and well tolerated in humans. One problem identified is consistently and accurately determining the depth of insertion of the enteroscope and the location of pathologic changes. The 2 reports of complications in humans (1 of perforation and 1 of subsequent abdominal pain and fever) imply that any fragile lesions observed during endoscopic examinations should not be crossed with the endoscope. Further studies with more dogs will help determine the safety and utility of this technique.

Double-balloon enteroscopy in two dogs. Latorre R, Ayala I, Soria F, et al. VET REC 161:587-591, 2007.