*5.4.4 Complications of DAE*

*Endoscopy in Small Bowel Diseases*

**60**

**Author** **Hirai et al, 2018**

**Holleran et al,** 

SBE

Retrospective

13

14 (1)

13 (12–15)

100

80 87

5

41.9

78.5

(0–141)

0

8

23

**2018**

**Sunada et al,** 

DBE

Retrospective

85

321 (3.8)

12.4 (8–20)

**2016**

**Navaneethan et** 

SBE or DBE

Retrospective

6

7 (1.16)

43

100

100

16

**al, 2014**

**Hirai et al, 2014**

**Gill et al, 2014** **Hirai et al,2010**

**Kondo et al,** 

DBE

Retrospective

8

18 (1.5)

**2010**

**Despott et al,** 

DBE

Prospective

11

18 (2)

15.4 (12–20)

73

73

9

20.5

25

**2009**

**Ohmiya et al,** 

DBE

Retrospective

16

NA

NA [8–20]

96

69

0

16

31

**2009**

**Pohl et al, 2007**

**Fukumoto et al,** 

**2007**

**Table 4.**

*enteroscopy, BGE- balloon guided enteroscopy [78–82].*

Push

R

16

15 (1.5)

17 (12–20)

80

60

0

10

40

enteroscopy

DBE

Prospective

193

35 (1.52)

NA *Summary of studies on endoscopic balloon dilatation of Crohn's disease small bowel strictures with device assisted enteroscopy (DAE); SBE- single balloon enteroscopy, DBE- double balloon* 

NA

74

0

12

26

DBE

Retrospective

25

55 (2.2)

DBE

Retrospective

10

17 (1.8)

13.5 (10–16.5)

NA

72 100

87.5

0

72

0

11

22

[12–18]

80

70

20

14

DBE

Retrospective

65

NA

80

80

1.5

48

[12–18]

SBE or DBE

Prospective

95

90 (1)

15 (8–20)

94

70

0

24

NA

**DAE system**

**Study design**

**CD** 

**Total number** 

**Dilation** 

**Technical** 

**Clinical** 

**Perforation** 

**Follow up** 

**Recurrence** 

**rate (%)**

**(months)**

**(%)**

**success (%)**

**success (%)**

**diameter: mean**

**(range) (mm)**

**(n)**

**of dilations (per** 

**patient mean)**

Major complications like bleeding, perforation or pancreatitis with DAE are found in about 0.72% (which may be higher in patients with Crohn's disease). Rate of perforation with DAE is around 0.11% according to results of a large Japanese registry of nearly thirty thousand patients. The risk of perforation was nine fold higher in IBD patients on steroids [88]. The rate of perforation with endoscopic balloon dilatation can be as high as 9% [60]. Bleeding after DAE has been reported in around 2.5% which is mostly self limiting [61]. Pancreatitis can occur in upto 0.3% patients after DAE from antegrade approach [89]. In paediatric IBD settings, although overall complication rates 0f upto 5.4% is reported, none reported major complications even with therapeutic procedures [75].
