Capsule endoscopy in small bowel tumors: A multicenter Korean study

Cheung, Dae Young; Lee, In Seok; Chang, Dong Kyung; Kim, Jin Oh; Cheon, Jae Hee; Jang, Byung Ik; Kim, Yong Sik; Park, Cheol Hee; Lee, Kwang Jae; Shim, Ki Nam; Ryu, Ji Kon; Hyuk, Jae; Moon, Jeong Seop; Ye, Byong Duk; Kim, Kyung Jo; Lim, Yun Jeong; Choi, Myung-Gyu; Chun, Hoon Jai

doi:10.1111/j.1440-1746.2010.06292.x

Cited by 72 publications

(55 citation statements)

References 32 publications

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“…Although we found significantly more small bowel tumors in female, many recent larger studies of small bowel tumors did not confirm this finding and most demonstrated male predomination in 60%-65% [24][25][26] . Thus, the finding in our study might be from type I error.…”

Section: Characteristics Of Patients According To the Etiologycontrasting

confidence: 53%

Yield, etiologies and outcomes of capsule endoscopy in Thai patients with obscure gastrointestinal bleeding

Pongprasobchai¹

2013

WJGE

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AIM:To investigate the yield, etiologies and impact of capsule endoscopy (CE) in Thai patients with obscure gastrointestinal bleeding (OGIB). METHODS:The present study is a retrospective cohort study. All patients with OGIB who underwent CE in Siriraj Hospital, Bangkok, Thailand during 2005-2009 were included in the study. All the patients' medical records and results of the CE videos were reviewed. CE findings were classified as significant, suspicious/equivocal and negative. Sites of the lesions were located to duodenum, jejunum, jejunoileum, ileum and diffuse lesions by the localization device of the CE. Impact of CE on the patients' management was defined by any investigation or treatment given to the patients that was more than an iron supplement or blood transfusion. Patients' outcomes (rebleeding, persistent bleeding, anemia or requirement of blood transfusion) were collected from chart reviews and direct phone interviews with the patients. RESULTS:Overall, there were 103 patients with OGIB included in the study. Mean age of the patients was 64 ± 16 years (range 9-88 years) and 57 patients (55%) were male. Types of OGIB were overt in 80 (78%) and occult in 23 patients (22%). The median time interval of CE after onset of OGIB was 10 d (range 1-180 d). The median time of follow-up was 19 mo (range 1-54 mo). Capsules reached caecum in 77 patients (74%) and capsule retention was found in 1 patient (1%). The diagnostic yield of CE revealed significant lesions in 37 patients (36%), suspicious/equivocal lesions in 15 patients (15%) and 51 patients (49%) had negative CE result. Among the significant lesions, the bleeding etiologies were small bowel ulcers in 44%, angiodysplasia in 27%, small bowel tumor in 13%, miscellaneous in 8% and active bleeding without identifiable causes in 8%. Patients with small bowel ulcers were significantly associated with the use of non-steroidal anti-inflammatory drugs (48%, P = 0.034), while patients with small bowel tumors were more commonly female (86%, P = 0.043) compared to the other etiologies. The rate of rebleeding, persistent bleeding or anemia in patients with positive, equivocal and negative CE results were 5%, 0% and 18%, respectively (P = 0.078). All the 9 patients with rebleeding after negative CE were subsequently found to be from hematologic disorders (4), colonic diverticulosis (2), colonic Dieulafoy's (1), hemorrhoid (1) and hemosuccus pancreaticus (1). Results of CE had a positive impact on the patients' management in 35% of the patients whose results were positive, but none on the patients whose results were equivocal or negative CE (P < 0.001). CONCLUSION:In Thai OGIB patients, CE had low yield and small bowel ulcer was most common. Positive CE impacted managements and outcomes. Negative CE caused low rebleeding.

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Section: Characteristics Of Patients According To the Etiologycontrasting

confidence: 53%

Yield, etiologies and outcomes of capsule endoscopy in Thai patients with obscure gastrointestinal bleeding

Pongprasobchai¹

2013

WJGE

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“…It has been used in patients with obscure gastrointestinal bleeding where other investigations have been inconclusive [29]. A capsule endoscopy better visualizes and characterizes subtle mucosal lesions compared to magnetic resonance enterography (MRE).…”

Section: Symptomatology and Diagnosismentioning

confidence: 99%

Small Bowel Adenocarcinoma – Report of Two Cases and Review of Literature

2012

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Although accounting for 90 % of the intestinal surface area, small bowel adenocarcinomas are not common. The majority of these lesions are incidentally detected during laparotomy for intestinal obstruction or perforation. The symptoms associated with these lesions are not very specific and preoperative diagnosis is rare. We report two cases of jejunal adenocarcinomas detected in patients undergoing laparotomy for acute abdomen and review the literature for small bowel adenocarcinomas.

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“…The most frequent indications for capsule endoscopy in malignant tumors were obscure gastrointestinal bleeding, followed by abdominal pain and weight loss. Thirty of 57 tumors were found exclusively by capsule endoscopy and they were smaller in size compared to the other tumors detected in radiological studies [55].…”

Section: Small Bowel Tumorsmentioning

confidence: 99%