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

2017 â—½  
Vol 05 (06) â—½  
pp. E463-E470 â—½  
Author(s):  
Connor Johnston â—½  
Diana Yung â—½  
Alka Joshi â—½  
John Plevris â—½  
Anastasios Koulaouzidis
Keyword(s):  
Small Bowel â—½  
Capsule Endoscopy â—½  
Tertiary Care â—½  
Case Series â—½  
Bowel Cancer â—½  
Deficiency Anemia â—½  
Gastrointestinal Neoplasms â—½  
Small Bowel Cancer â—½  
Tertiary Center â—½  
Small Bowel Malignancy

Abstract Background and study aims Small bowel cancer is rare, accounting for < 5 % of all gastrointestinal neoplasms. Capsule endoscopy has become the procedure of choice for non-invasive diagnosis of small bowel diseases. Data on capsule endoscopy diagnosis of small bowel cancer are limited. The objective of the study was to determine the frequency, indications and diagnostic work-up of patients with small bowel malignancy found by capsule endoscopy at a Scottish tertiary center. Patients and methods In this retrospective study, records all patients who underwent small bowel capsule endoscopy at our center over a 10-year period were reviewed for possible malignancy. Further data were gathered on preceding and subsequent investigations, management and outcome of these patients.  Results From 1949 studies, small bowel malignancies were diagnosed in only 7 patients (0.36 %; 2F/5M; median age 50, range 34 – 67). The main indication was iron-deficiency anemia (n = 5). Prior to capsule endoscopy, 6 of 7 patients had bidirectional endoscopies and one had gastroscopy. All prior investigations were normal or nondiagnostic. Two of 7 experienced capsule retention. Five of 7 underwent surgery. Four patients died, giving a 5-year survival rate of 42.9 %. Conclusion Small bowel malignancies diagnosed by capsule endoscopy are rare, and the median age of 50 indicates they are more common in relatively younger patients. Capsule endoscopy is effective at diagnosing a rare malignancy when other imaging modalities have failed.

PTU-011 Small Bowel Malignancy in Patients Undergoing Capsule Endoscopy in A Tertiary Care Academic Institution

Gut â—½  
2016 â—½  
Vol 65 (Suppl 1) â—½  
pp. A57.1-A57
Author(s):  
C Johnston â—½  
DE Yung â—½  
A Koulaouzidis â—½  
J Plevris
Keyword(s):  
Small Bowel â—½  
Capsule Endoscopy â—½  
Tertiary Care â—½  
Academic Institution â—½  
Small Bowel Malignancy

scholarly journals Malignant Small Bowel Tumors: Diagnosis, Management and Prognosis

10.20344/amp.6479 â—½  
2015 â—½  
Vol 28 (4) â—½  
pp. 448 â—½  
Author(s):  
Hélder Cardoso â—½  
João Tiago Rodrigues â—½  
Margarida Marques â—½  
Armando Ribeiro â—½  
Filipe Vilas-Boas â—½  
...  
Keyword(s):  
Small Bowel â—½  
Capsule Endoscopy â—½  
Imaging Techniques â—½  
Bowel Cancer â—½  
First Year â—½  
Small Bowel Tumors â—½  
Small Bowel Cancer â—½  
Endoscopic Techniques â—½  
High Degree â—½  
Late Stages

<p><strong>Purpose:</strong> 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.<br /><strong>Material and Methods:</strong> 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.<br /><strong>Results:</strong> 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.<br /><strong>Discussion:</strong> 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.<br /><strong>Conclusion: </strong>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.</p>

scholarly journals Incidence of small bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy

2017 â—½  
Vol 05 (07) â—½  
pp. E622-E626 â—½  
Author(s):  
Jasmijn Haanstra â—½  
Abdul Al-Toma â—½  
Evelien Dekker â—½  
Steven Vanhoutvin â—½  
Fokko Nagengast â—½  
...  
Keyword(s):  
Small Bowel â—½  
Early Detection â—½  
Lynch Syndrome â—½  
Prospective Study â—½  
Capsule Endoscopy â—½  
Bowel Cancer â—½  
Video Capsule Endoscopy â—½  
Small Bowel Cancer â—½  
Increased Risk â—½  
Malignant Lesions

Abstract Background and study aims Lynch syndrome (LS) patients have an increased risk of small bowel cancer. The question is whether surveillance will lead to early detection of (pre)malignant lesions. We recently reported on prevalence of small bowel neoplasia (SBN) in LS patients as assessed by video capsule endoscopy (VCE). The aim of this prospective study was to determine the incidence of SBN. Patients and methods Asymptomatic LS patients who underwent a VCE were invited to undergo a second VCE procedure 2 years later. If abnormalities or polypoid lesions larger than 1 cm were detected, subsequent endoscopic procedures were performed. Results A total of 155 (78 %) of the initial 200 patients underwent a second VCE procedure after a mean of 2.2 (range 1 – 6) years. In 17 of the 155 (11 %) patients possibly significant lesions were detected, which required further investigation by means of gastroduodenoscopy (n = 8) or balloon-assisted endoscopy (n = 9). These procedures revealed no SBN. Conclusion No SBN was found after 2 years. Surveillance of the small bowel by VCE does not seem to be warranted in asymptomatic LS patients. This study was registered in the Clinical Trials.gov registry with identifier NCT00898768.

Small Bowel Cancer in Crohnʼs Disease: A Case Series and Review of Literature

2009 â—½  
Vol 104 â—½  
pp. S466-S467
Author(s):  
Sara Taylor â—½  
Leticia Luz â—½  
Talha Malik â—½  
Shajan Peter â—½  
Alexandra Gutierrez â—½  
...  
Keyword(s):  
Small Bowel â—½  
Case Series â—½  
Bowel Cancer â—½  
Review Of Literature â—½  
Small Bowel Cancer

Video Capsule Endoscopy In Comparison To Radiological Examination In Detection Of Small Bowel Lesions

QJM â—½  
2021 â—½  
Vol 114 (Supplement_1) â—½  
Author(s):  
Amir Helmy Samy â—½  
Nevine Ibrahim Musa â—½  
Shereen Abou Bakr Saleh â—½  
Ahmed Sayed Elgammal
Keyword(s):  
Small Bowel â—½  
Capsule Endoscopy â—½  
Positive Contrast â—½  
Video Capsule Endoscopy â—½  
Vascular Lesions â—½  
Deficiency Anemia â—½  
Mesenteric Angiography â—½  
Upper Gi â—½  
Negative Results â—½  
Upper Gi Endoscopy

Abstract BACKGROUND Small bowel obscured its lesions as secrets which were difficult to diagnose before video capsule endoscopy as a new modality for investigation. Aim of the study Evaluation of video capsule endoscopy in comparison to radiological examination in detection of small bowel lesions. Patients and methods Fifty patients were recruited from Kafrawy Video Capsule Endoscopy Unit of Internal Medicine Department and endoscopy unit of Ain Shams University Hospital. The study included patients with occult or overt GIT bleeding, patients with unexplained microcytic iron deficiency anemia, patients with chronic diarrhea and abdominal pain, with normal upper GI endoscopy and colonoscopy. Exclusion of any patient younger than 18 years old, has intestinal stricture, achalasia, or dysphagia. All patients were studied biochemically with CBC and radiological by CT pelvis and abdomen with IV and oral positive contrast some of them were radiologically examined with CTE or CT mesenteric angiography. All patients were endoscopically examined by OGD, colonoscopy, VCE, and some of them were examined also with enteroscope. Results The study revealed that the detection rate of SB lesions with VCE was 84%. In the current study, (44%) of cases had AVMs, (72.73) % of them were above the age of forty five, and (27.27) % were below the age of forty five. All patients who were investigated with CT mesenteric angiography revealed negative results. In this study (20) % of patients had SB masses and polyps, (70) % of them were at age of forty five or more and only (30) % of them were below the age of forty five. All patients underwent CT pelvis and abdomen with IV and oral positive contrast, and we found that all patients had a negative results regarding the SB lesions. In comparison between CTE and VCE in detection of SB vascular lesions CTE did not detect SB vacular lesions. On the other hand, VCE detected the AVMs in the cases with negative CTE results. In this study one patient (2)% was diagnosed with hookworm infection. All patient underwent for OGD. We found that (20)% of patients had a significant gastric or duodenal lesions (proximal to the papilla) by VCE but missed by upper GI endoscopy. In our study the concomitant of VCE and enteroscope increase the detection of SB vascular lesions than isolated use of VCE only. Conclusion VCE has a high detection rate of SB lesions (84)%. CTE has a low significance in detection of SB vascular lesions and CT mesenteric angiography sensitivity relatively low. AVMs more common with increasing the age. PHE and SB ectopic varicies, were found to be common causes of GIT bleeding in CLD patient. There is a significant rate of missed gastric and duodenal (proximal to the papilla) lesions that the cause of GIT bleeding and unexplained iron deficiency anemia in OGD examination that were detected by VCE.

Diagnostic yield of magnetically assisted capsule endoscopy versus gastroscopy in recurrent and refractory iron deficiency anemia

Endoscopy â—½  
10.1055/a-0750-5682 â—½  
2018 â—½  
Vol 51 (05) â—½  
pp. 409-418 â—½  
Author(s):  
Hey-Long Ching â—½  
Melissa F. Hale â—½  
Matthew Kurien â—½  
Jennifer A. Campbell â—½  
Stefania Chetcuti Zammit â—½  
...  
Keyword(s):  
Small Bowel â—½  
Iron Deficiency â—½  
Iron Deficiency Anemia â—½  
Capsule Endoscopy â—½  
Diagnostic Yield â—½  
Deficiency Anemia â—½  
Gi Tract â—½  
Upper Gi â—½  
Upper Gi Tract â—½  
Magnetically Assisted

Abstract Background Small-bowel capsule endoscopy is advocated and repeat upper gastrointestinal (GI) endoscopy should be considered for evaluation of recurrent or refractory iron deficiency anemia (IDA). A new device that allows magnetic steering of the capsule around the stomach (magnetically assisted capsule endoscopy [MACE]), followed by passive small-bowel examination might satisfy both requirements in a single procedure. Methods In this prospective cohort study, MACE and esophagogastroduodenoscopy (EGD) were performed in patients with recurrent or refractory IDA. Comparisons of total (upper GI and small bowel) and upper GI diagnostic yields, gastric mucosal visibility, and patient comfort scores were the primary end points. Results 49 patients were recruited (median age 64 years; 39 % male). Combined upper and small-bowel examination using the new capsule yielded more pathology than EGD alone (113 vs. 52; P < 0.001). In upper GI examination (proximal to the second part of the duodenum, D2), MACE identified more total lesions than EGD (88 vs. 52; P < 0.001). There was also a difference if only IDA-associated lesions (esophagitis, altered/fresh blood, angioectasia, ulcers, and villous atrophy) were included (20 vs. 10; P = 0.04). Pathology distal to D2 was identified in 17 patients (34.7 %). Median scores (0 – 10 for none – extreme) for pain (0 vs. 2), discomfort (0 vs. 3), and distress (0 vs. 4) were lower for MACE than for EGD (P < 0.001). Conclusion Combined examination of the upper GI tract and small bowel using the MACE capsule detected more pathology than EGD alone in patients with recurrent or refractory IDA. MACE also had a higher diagnostic yield than EGD in the upper GI tract and was better tolerated by patients.

scholarly journals Management of Advanced Small Bowel Cancer

2018 â—½  
Vol 19 (12) â—½  
Author(s):  
Alberto Puccini â—½  
Francesca Battaglin â—½  
Heinz-Josef Lenz
Keyword(s):  
Small Bowel â—½  
Bowel Cancer â—½  
Small Bowel Cancer

scholarly journals Placenta Accreta Overlying a Caesarean Section Scar: A 10-Year Experience in a Tertiary-Care Centre in Portugal

10.20344/amp.14001 â—½  
2021 â—½  
Vol 34 (4) â—½  
pp. 266
Author(s):  
Margarida Cal â—½  
Carla Nunes â—½  
Nuno Clode â—½  
Diogo Ayres-de-Campos
Keyword(s):  
Cesarean Section â—½  
Placenta Accreta â—½  
Placenta Previa â—½  
Tertiary Care â—½  
Case Series â—½  
Morbidity And Mortality â—½  
Team Approach â—½  
Tertiary Center â—½  
Placenta Accreta Spectrum â—½  
Spectrum Disorders

Introduction: Placenta accreta spectrum disorders are among the leading causes of maternal morbidity and mortality and their prevalence is likely to increase in the future. The risk of placenta accreta spectrum disorders is highest in cases of placenta previa overlying a previous cesarean section scar. Few studies have evaluated placenta accreta spectrum disorders in Portugal. The aim of this study was to review the cases of placenta accreta spectrum overlying a cesarean section scar managed in a Portuguese tertiary center over the last decade.Material and Methods: Retrospective, cross-sectional study, with data collected from hospital databases. Only cases with histopathological confirmation of placenta accreta spectrum were included.Results: During the study period, 15 cases of placenta accreta spectrum overlying a cesarean section scar were diagnosed (prevalence 0.6/1000). All cases were diagnosed antenatally. A transverse cesarean section was present in all cases; 13 were managed by a scheduled multidisciplinary approach, while two required emergent management. Total or subtotal hysterectomy was performed in 12 cases. There were no cases of maternal or neonatal death. Histopathological evaluation confirmed nine cases of placenta accreta, three cases of placenta increta and three cases of placenta percreta.Discussion: Early antenatal diagnosis is important for a programmed multidisciplinary management of these cases, which may reduce potential morbidity and mortality and ensure better obstetric outcomes.Conclusion: This case series of placenta accreta spectrum overlying a cesarean section scar reports the reality of a tertiary-care perinatal center in Portugal, in which no maternal or neonatal mortality due to placenta accreta spectrum was registered over the last decade; this may be attributed to prenatal diagnosis and a coordinated multidisciplinary team approach.

Risk factors for small bowel cancer in Crohn's disease

10.1007/bf01296557 â—½  
1992 â—½  
Vol 37 (8) â—½  
pp. 1179-1184 â—½  
Author(s):  
Bret A. Lashner
Keyword(s):  
Risk Factors â—½  
Crohn’S Disease â—½  
Small Bowel â—½  
Crohn's Disease â—½  
Bowel Cancer â—½  
Small Bowel Cancer

Small Bowel Cancer (Excluding Gastrointestinal Stromal Tumors and Carcinoid)

2018 â—½  
pp. 69-81
Author(s):  
Alireza Hamidian Jahromi â—½  
Roger H. Kim â—½  
Quyen D. Chu â—½  
Benjamin D. Li
Keyword(s):  
Small Bowel â—½  
Gastrointestinal Stromal Tumors â—½  
Bowel Cancer â—½  
Small Bowel Cancer â—½  
Stromal Tumors
Sign in / Sign up

Export Citation Format

Share Document