Small bowel polyps and tumours: endoscopic detection and treatment by double‐balloon enteroscopy

Fry, Lucía C.; Neumann, Helmut; Kuester, Doerthe; Kuhn, Raphael; Bellutti, Michael; Malfertheiner, P.; Mönkemüller, Klaus

doi:10.1111/j.1365-2036.2008.03864.x

Cited by 56 publications

(59 citation statements)

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“…In the past, the diagnosis of small bowel tumors was made mainly through SBFT, abdominal CT, or even laparotomy; however, more accurate diagnosis for small bowel tumors became possible after the development of CE and DBE. The frequency of small bowel tumors in patients who receive CE has been reported to be 1.6-8.9% [4][5][6][7][8][9][10], while the frequency in patients who receive DBE is 10.0, 11.5 and 13.9% according to studies performed in Germany, Portugal, and Japan, respectively [15][16][17]. This difference is because DBE is usually performed to confirm abnormal findings that have been detected by other imaging studies, including CE.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Until only recently, primary surgical resection and IOE were the only available possibilities for treating polyps in the mid-small bowel in patients with PJS [73][74][75][76] . DBE and video capsule enteroscopy have changed this approach and it is now possible to not only to perform endoscopic surveillance and diagnose these lesions, but also to resect them [37,58,73,77,78] . Many reports on DBE have suggested that this new method may be able to replace at least IOE in many circumstances [63,79,80] .…”

Section: Overall Experience Of Pjs Patientsmentioning

confidence: 99%

“…A recent retrospective multicenter survey in four countries has indicated a complication rate of 0.8% (13/1728) in diagnostic procedures and 4.3% (27/634) for therapeutic DBE, and there were no fatal cases [63,84,85] . During DBE, careful attention must be paid not to insufflate too much air, because this induces intestinal loop formation and impedes deep advancement [73] . With CO2 insufflation, we solved this problem completely.…”

Section: Overall Experience Of Pjs Patientsmentioning

confidence: 99%

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Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Kopáčová

Tachecí²,

Rejchrt³

et al. 2009

WJG

195

183

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Peutz-Jeghers syndrome (PJS) is an inherited, autosomal dominant disorder distinguished by hamartomatous polyps in the gastrointestinal tract and pigmented mucocutaneous lesions. Prevalence of PJS is estimated from 1 in 8300 to 1 in 280 000 individuals. PJS predisposes sufferers to various malignancies (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular tumors). Bleeding, obstruction and intussusception are common complications in patients with PJS. Double balloon enteroscopy (DBE) allows examination and treatment of the small bowel. Polypectomy using DBE may obviate the need for repeated urgent operations and small bowel resection that leads to short bowel syndrome. Prophylaxis and polypectomy of the entire small bowel is the gold standard in PJS patients. Intraoperative enteroscopy (IOE) was the only possibility for endoscopic treatment of patients with PJS before the DBE era. Both DBE and IOE facilitate exploration and treatment of the small intestine. DBE is less invasive and more convenient for the patient. Both procedures are generally safe and useful. An overall recommendation for PJS patients includes not only gastrointestinal multiple polyp resolution, but also regular lifelong cancer screening (colonoscopy, upper endoscopy, computed tomography, magnetic resonance imaging or ultrasound of the pancreas, chest X-ray, mammography and pelvic examination with ultrasound in women, and testicular examination in men). Although the incidence of PJS is low, it is important for clinicians to recognize these disorders to prevent morbidity and mortality in these patients, and to perform presymptomatic testing in the first-degree relatives of PJS patients.

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“…Bu has ta la rın kap sül en dos ko pi ya da çift ba lon ente ros ko pi ile de ğer len di ril me le ri öne ril mek tedir. 12,13 Bu tet kik ola nak la rı ol ma yan mer kez ler de, bi zim has ta la rı mız da da ol du ğu gi bi MR-en te rok lisis yol gös te ri ci ol mak ta dır.…”

Section: Discussionunclassified

Evaluation of Our Pediatric Cases with Peutz-Jeghers Syndrome; Experience of Ondokuz Mayıs University

Dinler¹,

Barlık²,

Can³

et al. 2011

Turkiye Klinikleri J Med Sci

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590Peutz-Jeghers Sendromlu Çocuk Olgularımızın Değerlendirilmesi; Ondokuz Mayıs Üniversitesi Deneyimi Ö ÖZ ZE ET T A Am ma aç ç: : Pe utz-Jeg hers sen dro mu, du dak lar da ve mu ko za lar da me la no tik ma kül ler ve gas troin tes ti nal ka nal da po li po zis ile ka rak te ri ze bir has ta lık tır. Or ta la ma ta nı al ma ya şı nın 20'li yıl lar oldu ğu bi li nen bu tab lo, er ken ço cuk luk dö ne min de tek rar la yan ka rın ağ rı la rı ve dü zel me yen de mir ek sik li ği ane mi si gi bi da ha sin si bul gu lar la kar şı mı za çı ka bi lir. Bu ya zı da ama cı mız ço cuk luk ça-ğın da Pe utz-Jeg hers sen dro mu ta nı sıy la iz le nen has ta la rı mı zın baş vu ru ya kın ma la rı, ta nı ve te davi iz lem le ri ile il gi li de ne yim le ri mi zi pay laş mak tır. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Pe utz-Jeg hers sen dro mu ta nı sıy la iz le nen beş has ta nın baş vu ru ya kın ma la rı, kli nik, la bo ra tu var, en dos ko pik ve his to pa to lojik bul gu la rı ve iz lem sü reç le ri ile il gi li ve ri ler de ğer len di ril di. B Bu ul l g gu u l la ar r: : Has ta ne mi ze baş vu ru yaş or ta la ma la rı 7.3 ± 3 (2.5-10) yıl dı. Ka rın ağ rı sı has ta la rın hep sin de (%100), akut ka rın tab lo su (inva ji nas yon) iki (%40), kan sız lık-so luk luk üç (%60) has ta da ilk baş vu ru ya kın ma sıy dı. Has ta la rın hep sin de du dak lar da hi per pig men te ma kül ler ve po zi tif ai le öy kü sü var dı. Ha mar to ma töz ya pı daki po lip ler je ju num (%100), mi de (%80), rek tum (%60), ve du o de num da (%20) sap tan dı. S So o n nu uç ç: : Te da viy le dü zel me yen de mir ek sik li ği ane mi si ve tek rar la yı cı ka rın ağ rı la rı olan ço cuk lar da, ai le öy-kü sü nün po li po zis açı sın dan iyi alın ma sı ve Pe utz-Jeg hers sen dro mu nun ayı rı cı ta nı da dü şü nül -me si, bu has ta la rın ve var sa di ğer ai le bi rey le ri nin ta nı ve iz lem le ri açı sın dan ye rin de ola cak tır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Pe utz-Jeg hers sen dro mu; ane mi, de mir ek sik li ği; ka rın ağ rı sı; hi per pig men tas yon; in tes ti nal po lip ler A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : Pe utz-Jeg hers syndro me is a di se a se cha rac te ri zed by me la no tic ma cu les on the lips and the mu co us membranes and poly po sis in the gas tro in tes ti nal trac tus. This con di ti on which is known to be di ag no sed aro und 20 ye ars of age can ap pe ar with re cur rent ab do mi nal pa in and cause mo re in si di o us symptoms as ref rac tory iron de fi ci ency ane mi a in early child ho od. In this re port, we ai med to sha re our ex pe ri en ces on the app li ca ti on comp la ints, di ag no sis and the ra pe utic mo ni to ri za ti on of our pa ti ents who we re fol lo wed up with di ag no sis of Pe utz-Jeg hers syndrome in child ho od. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : Admission comp la ints, cli ni cal, la bo ra tory, en dos co pic and his to pat ho lo gi cal fin dings and da ta of mo ni to ri za ti on of five pa ti en...

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Small bowel polyps and tumours: endoscopic detection and treatment by double‐balloon enteroscopy

Abstract: SUMMARYBackground Double-balloon enteroscopy has allowed us not only to inspect deeply the small bowel but also to carry out interventions for diseases of the small bowel.

Cited by 56 publications

References 28 publications

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

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

Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Evaluation of Our Pediatric Cases with Peutz-Jeghers Syndrome; Experience of Ondokuz Mayıs University

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