What is a double-balloon enteroscopy?

A double-balloon enteroscopy, also known as a push-and-pull endoscopy, is an endoscopic technique used to visualize the entire gastrointestinal tract. It is used to help in the diagnosis of a variety of digestive disorders.

Your child’s doctor may recommend this test if your child is experiencing unexplained bleeding in the GI tract, has anemia or if abnormalities — such as small bowel polyps or vascular lesions — have been found during previous bowel imaging.

A double-balloon enteroscopy uses a long endoscope (a thin, flexible tube with a light, camera and balloon on the end) that is fitted into a long overtube with a second balloon on the tip. The balloons can be inflated or deflated to anchor the overtube and move the endoscope further into your child’s small intestine. When the overtube is withdrawn, your child’s small intestine can be shortened and straightened, making it easier to position the inner endoscope and view your child’s small bowel.

Performed in conjunction with our adult gastroenterology colleagues at the Hospital of the University of Pennsylvania (HUP), a double-balloon enteroscopy is performed after your child has been sedated. The endoscope and overtube will be inserted into your child’s mouth and advanced through the esophagus and stomach deep into the small intestine. The endoscope allows special tools — such as electrocautery or biopsy instruments — to be guided to the tip of the endoscope.

Because this procedure can take one to three hours, and because there is a risk for certain complications, doctors will usually only conduct a double-balloon enteroscopy if another diagnostic procedure has shown an abnormality in your child’s small intestine that is beyond the reach of conventional endoscope or colonoscopes.