Double-balloon endoscopy (DBE) constitutes a major advance in endoscopic examination of the small intestine. Traditionally, methods of small intestinal endoscopy have been limited to the tube method, in which the endoscope is advanced by peristalsis, and the push method, whereby the endoscope is pushed in while the stomach and duodenum are straightened. However, both methods are painful for patients and require specialist skills, and observation of a sufficiently wide area and endoscopic treatment can be difficult. In many cases, this meant that radiography was used for detailed investigation of the small intestine, as described in detail in other chapters. As radiography can only provide indirect findings, however, definitive diagnosis of neoplastic or ulcerative lesions is difficult.
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