Abstract: Objective To evaluate the value of double-balloon enteroscopy (DBE) in the elderly patients with small intestinal diseases. Methods The clinical data of 418 patients with suspected small intestinal diseases who underwent double-balloon enteroscopy in the First Affiliated Hospital of Nanjing Medical University from January 2021 to May 2022 were retrospectively analyzed. The patients were divided into the young and middle-aged group (aged <60 years, n=357) and the elderly group (aged ≥60 years, n=61) . The diagnostic accuracy of DBE, etiology of small bowel disease, endoscopic treatment and complications were compared between the two groups. Results Small bowel bleeding and abdominal pain were the most common reasons for DBE in the elderly patients, accounting for 68.9% and 14.8%, respectively. The diagnostic accuracy was 90.1% in the elderly group,which was similar with that in the young and middle-aged group(93.8%)(P=0.251). The common diseases in the elderly group were intestinal ulcer and erosion (41.8%), vascular malformation (18.2%) and small intestinal tumor (12.7%),compared with Crohn's disease (57.1%), intestinal ulcer and erosion (24.5%) and diverticulum (4.5%) in the young and middle-aged group. The causes of small bowel diseases were significantly different between the two groups(P<0.001). 63.6% (7/11) of the elderly patients diagnosed as vascular malformations were successfully treated with DBE. No severe complications occurred in 418 patients. Conclusions DBE is a safe and effective method for the elderly patients with suspected small intestinal disease and has a high diagnostic accuracy. DBE is valuable for the treatment of vascular malformations in the elderly patients.

Key words: double-balloon enteroscopy, small intestine diseases, diagnosis, treatment