The Vanishing Frontiers of Therapeutic Enteroscopy

The last years saw the dawn of a paradigm shift in small bowel investigation and management.Once difficult to approach through both endoscopic and radiologic studies, small bowel evaluation underwent a game-changing revolution with the recent advent of new endoscopic and radiologic technologies.The radiologic revolution came from the development of computed tomography enterography (CTE) and magnetic resonance imaging enterography (MRE).The advantages over the old small bowel follow-through rapidly became evident, as superimposed 2-dimensional bowel loops were replaced by the new multiplanar small bowel reconstructions.Until recently, endoscopic techniques have been very limited either in the depth of insertion (push-enteroscopy), lack of therapeutic intervention or availability (probeenteroscopy) or invasiveness (intra-operatory enteroscopy).Hence, radiologic techniques have long been the mainstay of small bowel investigation.A little over a decade ago, another revolution in small bowel evaluation took place.Over a few years, two new endoscopic technologies emerged independently and the evaluation and management of small bowel pathologies have once again changed.Forever.The first endoscopic revolution came with capsule endoscopy (CE), a disruptive technology that rendered a once inaccessible organ at the reach of a small swallowable endoscopic capsule. 1 Gastroenterologists have rapidly