Clinically significant small-bowel pathology identified by double-balloon enteroscopy but missed by capsule endoscopy

Chong, A.; Chin, Bernard W.K.; Meredith, Christopher

doi:10.1016/j.gie.2006.04.007

Cited by 127 publications

(78 citation statements)

References 16 publications

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“…Finally, there is a risk of missing lesions, because of their tendency to grow extraluminally. Some authors believe double balloon enteroscopy to be superior to video capsule endoscopy for identifying small bowel tumours 67,68 . This method provides the possibility of obtaining biopsies (to rule out lymphoma), and of tattooing the site of GIST to make its peroperative localization easy during laparoscopic resection 69,70 .…”

Section: Small Bowelmentioning

confidence: 99%

Surgical management of gastrointestinal stromal tumours

Gervaz

Huber

Morel

2009

British Journal of Surgery

101

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Background: Over the past decade, gastrointestinal stromal tumours (GISTs) have served as a model for the application of tyrosine kinase inhibitors in the treatment of solid neoplasms. Operative and medical management of GISTs is rapidly evolving, but current guidelines appear restricted to basic non-organ-specific recommendations.Methods: A PubMed search was made of the English literature from 1998 to 2008 for references containing the terms 'gastrointestinal stromal tumours' and 'surgery'. This paper reviews the various operative strategies so far reported for GISTs within the digestive tract.Results: Many original procedures tailored to the specific characteristics of these rare sarcomas have been reported. GISTs exhibit distinct features, in particular an absence of metastases within locoregional lymph nodes. Operations requiring extended lymph node dissection, typically designed for adenocarcinomas, such as gastrectomy with extended lymph node dissection, Whipple's procedure and total mesorectum excision, are inappropriate for treating GISTs originating from the stomach, duodenum and rectum respectively.

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Section: Small Bowelmentioning

confidence: 99%

Surgical management of gastrointestinal stromal tumours

Gervaz

Huber

Morel

2009

British Journal of Surgery

101

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“…Although it is a minimally invasive test, capsule endoscopy enables the diagnosis of various disorders of the small intestine, such as vascular abnormalities, ulcerative lesions, and tumors [4][5][6][7][8][9][10]. However, false positive or false negative results for small bowel tumors are limitations of capsule endoscopy [11][12][13], and capsule retention occasionally occurs. Moreover, histologic confirmation is not available for capsule endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Small Bowel Tumors Diagnosed by Double-Balloon Endoscopy: KASID Multi-Center Study

Lee

Choi

et al. 2011

Dig Dis Sci

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Background Small bowel tumors are relatively rare, and their confirmative diagnosis before surgery is not easy. Aims This study was performed to investigate the clinical characteristics of patients with small bowel tumors who received double-balloon enteroscopy (DBE). Secondary end points were to evaluate the usefulness and safety of DBE for the diagnosis of patients with suspected SB tumors derived from other previous procedures. Methods We retrospectively analyzed consecutive DBE examinations to explore the small intestine in eight university hospitals over a 5-year period. Results A total of 877 DBE examinations (per oral 487, per anal 390) were performed in 645 patients (405 males, mean age 48.2 years). Small bowel tumors were diagnosed in 112 patients (17.4%), of which 38 patients had benign polyps, 29 had gastrointestinal stromal tumors/leiomyomata, 18 had lymphomas, 14 had adenocarcinomas, five had metastatic or invasive cancers, five had lipomas, and three patients had cystic tumors. The main reasons for DBE among patients with small bowel tumors were obscure gastrointestinal bleeding (OGIB, 40.2%) followed by abnormal imaging study (25.2%). The concordance rate of diagnoses based on DBE with diagnoses based on small bowel follow-through, CT, and capsule endoscopy among patients with small bowel tumors was 68.9% (42/61), 75.3% (70/93), and 78.3% (18/23), respectively. Therapeutic plans were changed due to the DBE results in 64.2% of patients with small bowel tumors. Conclusions Approximately one-sixth of patients who received DBE had small bowel tumors, and the most common reason for DBE among patients with small bowel tumors was OGIB. DBE is a useful method for the 123Dig Dis Sci (2011) 56:2920-2927 DOI 10.1007/s10620-011-1839 confirmative diagnosis of small bowel tumors and has a good clinical impact on therapeutic plans and short-term clinical results.

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“…In our study, balloon assisted enteroscopy performed biopsies, treated bleeding lesions and was capable of discovering tumors not seen on video capsule endoscopy, as described in literature. 39 However, this technique is not infallible, as certain technical limitations can result in an inconclusive small bowel examination. Zagorowicz et al, proposed that balloon assisted enteroscopy should be the next diagnostic tool after a normal or non significant capsule endoscopy examination, when symptoms strongly suggest a small bowel lesion.…”

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confidence: 99%

Malignant Small Bowel Tumors: Diagnosis, Management and Prognosis

et al. 2015

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adenocarcinoma (n = 11), seguido do sarcoma (n = 6), linfoma (n = 6) e tumores neuroendócrinos (n = 3). A principal forma de apresentação esteve relacionada com perdas hemáticas ou obstrução intestinal. Ao diagnóstico, 46% dos doentes tinham metástases distantes/tumor irressecável. A maioria dos tumores foi diagnosticada por técnicas endoscópicas (41%) ou imagiológicas (35%). No primeiro ano após o diagnóstico, 29% dos doentes faleceram. Na análise multivariada, o adenocarcinoma permaneceu fator independente para pior sobrevida. Discussão: Os doentes com adenocarcinoma apresentaram-se em estádios tardios e com tumores irressecáveis, contribuindo para um pior prognóstico. É necessário um elevado grau de suspeita clínica para o diagnóstico de cancro do intestino delgado. Conclusão: As características dos doentes foram globalmente consistentes com o descrito na literatura. A cápsula endoscópica e a enteroscopia assistida por balão são úteis no diagnóstico, gestão e vigilância do cancro do intestino delgado. Palavras-chave: Endoscopia por Cápsula; Neoplasias Intestinais; Portugal.ABSTRACT Purpose: Despite being rare entities, the incidence of malignant small bowel tumors seems to be rising. The development of capsule endoscopy and balloon assisted enteroscopy provided an advance in the assessment of small bowel lesions. We aim to describe the clinical and pathological characteristics of patients with small bowel cancer and ascertain what roles these endoscopic techniques currently have. Material and Methods:A retrospective study of patients diagnosed with small bowel cancer, from January 2010 to October 2014, was performed. The data was submitted to statistical analysis. Results: Of the 28 diagnosed patients, 54% were female. The mean age at diagnosis was 61 years. Adenocarcinoma was the most frequent tumor (n = 11), followed by sarcoma (n = 6), lymphoma (n = 6) and neuroendocrine tumors (n = 3). The main form of presentation was related to blood loss or intestinal obstruction. By the time of diagnosis, 46% of patients had distant metastasis/ unresectable cancer. Most of the tumors were diagnosed by endoscopic (41%) or imaging techniques (35%). In the first year after diagnosis, 29% of patients died. In multivariate analysis, adenocarcinoma remained an independent factor for worse survival. Discussion: Patients with adenocarcinoma presented at late stages and with unresectable tumors, contributing to a worse outcome. A high degree of clinical suspicion for the diagnosis of small bowel cancer is necessary. Conclusion:The characteristics of the patients were generally consistent with those described in the literature. Capsule endoscopy and balloon assisted enteroscopy are useful in the diagnosis, management and surveillance of small bowel cancer.

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Clinically significant small-bowel pathology identified by double-balloon enteroscopy but missed by capsule endoscopy

Cited by 127 publications

References 16 publications

Surgical management of gastrointestinal stromal tumours

Surgical management of gastrointestinal stromal tumours

Clinical Characteristics of Small Bowel Tumors Diagnosed by Double-Balloon Endoscopy: KASID Multi-Center Study

Malignant Small Bowel Tumors: Diagnosis, Management and Prognosis

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