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BACKGROUND: Double-balloon enterocopy (DBE) is still under evaluation, including its yield and safety aspects. OBJECTIVE: Our purpose was to consider the relationship between DBE and hyperamylasemia. DESIGN: Single-center prospective study. SETTING: Tertiary referral hospital, conducted from March to October 2006. PATIENTS: Thirty-five oral DBEs were carried out in 31 patients (17 men, 14 women). Serum amylase, lipase, C-reactive protein (CRP), and urine amylase were taken before the procedure and 4 and 24 hours after the investigation. Abdominal pain was evaluated with a 3-step scale. MAIN OUTCOME MEASUREMENTS: Only 1 patient had acute pancreatitis after DBE. RESULTS: An elevation of amylase levels after the procedure was found in 51.4% and abdominal pain or nausea or vomiting in 34.3%, but 8.6% of these patients had no hyperamylasemia after DBE. CRP was determined in 25 procedures and the serum lipase level in 14 of these 25 DBEs; elevation of both factors after the procedure was found in 36%. The CRP level was elevated in 60% after the procedure. We found a positive correlation between abdominal pain and serum lipase level (r = 0.72, P = .0032) and negative correlation between abdominal pain and age (r = -0.445, P = .0076). Significant hyperamylasemia seems to be associated with longer duration of DBE (borderline statistically significant, P = .045; 95% CI for difference of means 0.985-82.306). LIMITATIONS: Nonblinded nonrandomized study. CONCLUSIONS: Hyperamylasemia after DBE seems to be rather common, mainly in the longest examinations. Although association of significant hyperamylasemia and acute pancreatitis is possible, it is not obligatory. [ABSTRACT FROM AUTHOR]

Intraoperative enteroscopy is an invasive technique for small bowel investigation. It enables us to investigate the entire small intestine and to treat pathological findings by endoscopic or surgical means at the same time. The investigation is invasive and that is why the proper indication is mandatory. Forty-one intraoperative enteroscopies were performed at our center within a 10-year period. The procedure was diagnostic in 37/41 patients (90.2%); in 3 patients no pathology was found, and in 1 patient we found only previously diagnosed celiac disease. The investigation was therapeutic in 35/41 (85.4%) patients; 2 patients with small bowel ulcers did not require any intraoperative therapy. The pathological findings were arteriovenous malformations (found in 12 patients), small bowel NSAID-induced or Crohn’s ulcers (8 patients)—ulcerations and arteriovenous malformations were simultaneously found in three patients; carcinoid of the small intestine (5 patients); Peutz-Jeghers syndrome (5 patients); bleeding polyps (2 gastrointestinal stromal tumors, 1 paraganglioma, and 1 lipoma—in 4 patients); Rendu-Osler-Weber disease (2 patients); multiple cavernous hemangiomas in blue rubber bleb nevus syndrome (1 patient); Henoch-Schönlein purpura (1 patient); aortoenteral fistula (1 patient); and retrograde intussusception of Meckel’s diverticulum (1 patient). In five patients with Peutz-Jeghers syndrome, 6-22 hamartomas (median of 18 per session) were removed by means of endoscopic polypectomy during intraoperative enteroscopy. There were no major procedure-related complications in our series. Intraoperative enteroscopy is accepted as the ultimate diagnostic procedure for complete investigation of the small bowel. Despite the introduction of double-balloon enteroscopy into clinical practice, intraoperative enteroscopy will be reserved for those cases where double-balloon enteroscopy cannot be performed or fails to investigate the entire small intestine, especially to prevent excessive bowel resection. [ABSTRACT FROM AUTHOR]

Objective . The 13 C‐urea breath test ( 13 C‐UBT) is the most accurate non‐invasive method for diagnosis of Helicobacter pylori infection. However, several methodological issues have not been resolved yet. The aim of this study was to test different protocols of 13 C‐UBT to find the optimal test drink and sampling interval. Material and methods . 13 C‐UBT was performed at 3‐day intervals in 27 healthy volunteers using citric acid (test A), orange juice (B) and still water (C) as test drinks. Breath samples were collected from time 5 to 60 min. A total number of 2106 breath samples were analysed by isotope ratio mass spectrometry (cut‐off value 3.5). Results . Differences in delta values were greater than would be expected by chance (A versus B and A versus C at times 20, 25, 30, 35 and 40 min, p [ABSTRACT FROM AUTHOR]