Increased Prevalence of Colorectal Neoplasia in Korean Patients with Sporadic Duodenal Adenomas: A Case-Control Study

Abstract

Background/AimsRecent data from Western populations have suggested that patients with sporadic duodenal adenomas are at a higher risk for the development of colorectal neoplasia. In this study, we compared the frequency of colorectal neoplasia in patients with sporadic duodenal adenomas to healthy control subjects.MethodsThis retrospective case-control study used the databases of 3 teaching hospitals in Gyeonggi-do Province, South Korea. The colonoscopy findings of patients with sporadic duodenal adenomas were compared with those of age- and gender-matched healthy individuals who had undergone gastroduodenoscopies and colonoscopies during general screening examinations.ResultsBetween 2001 and 2008, 45 patients were diagnosed endoscopically with sporadic duodenal adenomas; 26 (58%) of these patients received colonoscopies. Colorectal neoplasia (42% vs 21%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.1 to 7.4) and advanced colorectal adenoma (19% vs 3%; OR, 9.0; 95% CI, 1.6 to 50.0) were significantly more common in patients with sporadic duodenal adenomas than in healthy control subjects.ConclusionsCompared with healthy individuals, patients with sporadic duodenal adenomas were at a significantly higher risk for developing colorectal neoplasia. Such at-risk patients should undergo routine screening colonoscopies.

Small Bowel Malignancies in Patients Undergoing Capsule Endoscopy for Iron Deficiency Anemia

“…The presence of duodenal adenomas, especially in young patients, suggests the possibility of hereditary polyposis syndrome, and indicates the need for colonoscopy to exclude colorectal neoplasms [ 19 , 20 ]. Some studies have reported a relationship between sporadic duodenal adenomas and colorectal adenomas [ 21 , 22 , 23 ]. An association between an increased risk of small bowel cancer and environmental factors, including alcohol consumption, smoking, red meat, and intake of sugary drinks, was reported, although the evidence is insufficient owing to the rarity of small bowel malignancies [ 17 ].…”

Premalignant Lesions of the Small Intestine

“…다른 일본 의 연구에서는 내시경적점막하박리절제술(endoscopic submucosal dissection, ESD)을 시행했을 때 잔존 병 변 비율이 낮았지만, 천공 및 지연 출혈의 비율이 높았다 [12,16]. 게다가, 십이지장은 췌액과 담즙에 노출되어 지 연성 천공의 위험이 높다고 알려졌다 [12,16] [20].…”