Incidence of Tumoral Pathology According to Study Using Capsule Endoscopy for Patients with Obscure Gastrointestinal Bleeding

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2007 Mar 16

PMID 17356941

Citations 13

Authors

E Estevez

B Gonzalez-Conde

J L Vazquez-Iglesias

P A Alonso

M de los Angeles Vazquez-Millan

R Pardeiro

Affiliations

Soon will be listed here.

Abstract

Background: Capsule endoscopy has involved a significant advance in techniques for imaging of the small bowel. Its most frequent indication is for studying patients with obscure gastrointestinal bleeding (OGIB). Small bowel tumors are infrequent, representing only 1% to 3% of all malignant gastrointestinal tumors. This study aimed to assess retrospectively the occurrence and characteristics of tumoral pathology diagnosed by means of capsule endoscopy in patients with OGIB.

Methods: A retrospective review analyzed the first 320 patients submitted to capsule endoscopy because of OGIB (166 with obscure overt bleeding and 154 with obscure occult bleeding) at a single center. The patients with a tumor diagnosis were analyzed in terms of incidence, characteristics, and treatment of OGIB pathology.

Results: Tumor incidence was of 7.18% (23/320), with 65.2% of the cases supported with histologic confirmation (15/23). Obscure overt bleeding was the most frequent form of presentation, with the jejunum as the most frequent location (65.2%). For 16 patients, an intervention was conducted with a healing intent. Capsule endoscopy allowed the diagnosis of two cecal adenocarcinomas missed by colonoscopy.

Conclusions: Small bowel tumors are not an infrequent cause of OGIB. Capsule endoscopy, even if it does not allow determination of the benign or malignant nature or the histologic type of the tumor, is a useful tool for the diagnosis and early management of these tumors.

Citing Articles

Small bowel malignancy in patients undergoing capsule endoscopy at a tertiary care academic center: Case series and review of the literature.

Johnston C, Yung D, Joshi A, Plevris J, Koulaouzidis A Endosc Int Open. 2017; 5(6):E463-E470.

PMID: 28573179 PMC: 5451279. DOI: 10.1055/s-0043-106186.

Clinical Efficacy of Various Diagnostic Tests for Small Bowel Tumors and Clinical Features of Tumors Missed by Capsule Endoscopy.

Han J, Hong S, Jang H, Jeon S, Cha J, Park S Gastroenterol Res Pract. 2015; 2015:623208.

PMID: 26229529 PMC: 4503554. DOI: 10.1155/2015/623208.

Gastrointestinal autonomic nerve tumors: a clinical review.

Meshikhes A, Al-Momen S J Gastrointest Surg. 2015; 19(6):1144-56.

PMID: 25805400 DOI: 10.1007/s11605-015-2798-z.

New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics.

Sanchez-Capilla A, de la Torre-Rubio P, Redondo-Cerezo E World J Gastrointest Pathophysiol. 2014; 5(3):271-83.

PMID: 25133028 PMC: 4133525. DOI: 10.4291/wjgp.v5.i3.271.

The contribution of the video capsule endoscopy in establishing the indication of surgical treatment in the tumoral pathology of the small bowel.

Vere C, Streba C, Rogoveanu I, Georgescu M, Pirvu D, Iordache S Curr Health Sci J. 2014; 38(2):69-73.

PMID: 24778844 PMC: 3994675.

References

Crosby J, Catton C, Davis A, Couture J, OSullivan B, Kandel R . Malignant gastrointestinal stromal tumors of the small intestine: a review of 50 cases from a prospective database. Ann Surg Oncol. 2001; 8(1):50-9. DOI: 10.1007/s10434-001-0050-4. View

Saurin J, Delvaux M, Gaudin J, Fassler I, Villarejo J, Vahedi K . Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy. 2003; 35(7):576-84. DOI: 10.1055/s-2003-40244. View

Selby W . Can clinical features predict the likelihood of finding abnormalities when using capsule endoscopy in patients with GI bleeding of obscure origin?. Gastrointest Endosc. 2004; 59(7):782-7. DOI: 10.1016/s0016-5107(04)00168-3. View

DiSario J, Burt R, Vargas H, McWhorter W . Small bowel cancer: epidemiological and clinical characteristics from a population-based registry. Am J Gastroenterol. 1994; 89(5):699-701. View

Desa L, Bridger J, Grace P, Krausz T, Spencer J . Primary jejunoileal tumors: a review of 45 cases. World J Surg. 1991; 15(1):81-6; discussion 86-7. DOI: 10.1007/BF01658970. View

Serour F, Dona G, Birkenfeld S, Balassiano M, Krispin M . Primary neoplasms of the small bowel. J Surg Oncol. 1992; 49(1):29-34. DOI: 10.1002/jso.2930490108. View

Viazis N, Papaxoinis K, Theodoropoulos I, Sgouros S, Vlachogiannakos J, Pipis P . Impact of capsule endoscopy in obscure small-bowel bleeding: defining strict diagnostic criteria for a favorable outcome. Gastrointest Endosc. 2005; 62(5):717-22. DOI: 10.1016/j.gie.2005.06.049. View

Brophy C, CAHOW C . Primary small bowel malignant tumors. Unrecognized until emergent laparotomy. Am Surg. 1989; 55(7):408-12. View

Kitiyakara T, Selby W . Non-small-bowel lesions detected by capsule endoscopy in patients with obscure GI bleeding. Gastrointest Endosc. 2005; 62(2):234-8. DOI: 10.1016/s0016-5107(05)00292-0. View

10.

Ashley S, Wells Jr S . Tumors of the small intestine. Semin Oncol. 1988; 15(2):116-28. View

11.

Maieron A, Hubner D, Blaha B, Deutsch C, Schickmair T, Ziachehabi A . Multicenter retrospective evaluation of capsule endoscopy in clinical routine. Endoscopy. 2004; 36(10):864-8. DOI: 10.1055/s-2004-825852. View

12.

Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini F . Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology. 2004; 126(3):643-53. DOI: 10.1053/j.gastro.2003.11.057. View

13.

Dabaja B, Suki D, Pro B, Bonnen M, Ajani J . Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients. Cancer. 2004; 101(3):518-26. DOI: 10.1002/cncr.20404. View

14.

Lewis B, Eisen G, Friedman S . A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy. 2005; 37(10):960-5. DOI: 10.1055/s-2005-870353. View

15.

Triester S, Leighton J, Leontiadis G, Fleischer D, Hara A, Heigh R . A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol. 2005; 100(11):2407-18. DOI: 10.1111/j.1572-0241.2005.00274.x. View

16.

Ell C, Remke S, May A, Helou L, Henrich R, Mayer G . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy. 2002; 34(9):685-9. DOI: 10.1055/s-2002-33446. View

17.

Zuckerman G, Prakash C, Askin M, Lewis B . AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 1999; 118(1):201-21. DOI: 10.1016/s0016-5085(00)70430-6. View

18.

Talamonti M, Goetz L, Rao S, Joehl R . Primary cancers of the small bowel: analysis of prognostic factors and results of surgical management. Arch Surg. 2002; 137(5):564-70; discussion 570-1. DOI: 10.1001/archsurg.137.5.564. View