Small bowel stromal tumors diagnosed by capsule endoscopy

2008 ◽  
Vol 149 (15) ◽  
pp. 697-701
Author(s):  
Márta Kovács ◽  
Péter Pák ◽  
Andrea Uhlyarik ◽  
Gábor Pák ◽  
Attila Török ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Clinical Symptoms ◽  
Intestinal Bleeding ◽  
Testing Time ◽  
Upper Endoscopy ◽  
Stromal Tumors ◽  
Definitive Therapy ◽  
Small Intestinal

Small intestinal stromal tumors acccount for approximately 35% of all gastrointestinal stromal tumors. Gastrointestinal bleeding is considered as one of the main clinical symptoms for SISTs. Capsule endoscopy has brought revolution in small bowel diagnostics, as it is considered the best method of visualisation of the entire small intestine. Besides, it is well tolerated by patients and is accompanied by a low number of complications. It is also indicated as the first diagnostic method in gastrointestinal bleeding of obscure origin, following negative upper endoscopy and colonoscopy. Case report: 2 patients (a male and a female, aged 58 and 69, respectively) presented with obscure gastrointestinal bleeding have been examined by capsule endoscopy after negative upper endoscopy and colonoscopy. Videorecords have been assessed in both cases by two independent experts. The capsule reached the Bauchin-valve in both cases during the 8 hours of the testing time and the entire small bowel was clearly visible. – Based on the capsule endoscopic images, for one of the two cases a tumor has been reported as the background of the small intestinal bleeding. In the other case we could mark the location of the bleeding, while we were unable to ascertain the type of the actively bleeding lesion during the test. In order to determine the accurate bleeding source double-balloon enteroscopy was performed in the second case. After surgery the histological and immunhistochemical tests have justified the presence of spindle cell GISTs. Taking into consideration the Fletcher-classification, for the tumor size and the mitotic index, both cases can be classified as a GIST of low malignant potencial. Conclusions: An early diagnosis and application of a definitive therapy become possible by using capsule endoscopy, therefore the chance of survival of the patients might be increased.

ID: 3520773 RHEMITT SCORE: PREDICTING THE RISK OF REBLEEDING FOR PATIENTS WITH MID-GASTROINTESTINAL BLEEDING SUBMITTED TO SMALL BOWEL CAPSULE ENDOSCOPY – A PROSPECTIVE VALIDATION

2021 ◽  
Vol 93 (6) ◽  
pp. AB350-AB351
Author(s):  
Rui S. Magalhães ◽  
Bernardo Sousa-Pinto ◽  
Tiago Cúrdia Gonçalves ◽  
Pedro Boal Carvalho ◽  
Bruno Rosa ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy

scholarly journals Massive Obscure Overt Gastrointestinal Bleed: An Unusual Cause diagnosed by Capsule Endoscopy

2012 ◽  
Vol 46 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Surjeet Singh ◽  
Chalapathi Rao ◽  
Surinder S Rana ◽  
Amit Bhauwala ◽  
Kartar Singh ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Unusual Case ◽  
Tropical Countries ◽  
Gastrointestinal Bleed ◽  
Common Causes

ABSTRACT Common causes for obscure overt gastrointestinal bleeding originating from the small bowel include small bowel angioectasias, Crohn's disease, ulcers and tumors. In tropical countries, intestinal ulcerations secondary to tuberculosis and parasitic infestations have also been described as causes of gastrointestinal bleeding. We present a very unusual case of massive obscure overt gastrointestinal bleeding due to massive hookworm infestation of the small bowel that was diagnosed by capsule endoscopy and successfully treated with oral albendazole. How to cite this article Rao C, Sharma A, Rana SS, Bhauwala A, Singh S, Singh K, Bhasin DK. Massive Obscure Overt Gastrointestinal Bleed: An Unusual Cause diagnosed by Capsule Endoscopy. J Postgrad Med Edu Res 2012;46(1):37-39.

Laparoscopic Small Bowel Resection And Anastmosis For Small Proximal Jejunal Gastrointestinal Stromal Tumor Presented With Acute Massive Lower Gastrointestinal Bleeding: Case report and Literature review

2020 ◽  
Author(s):  
khaled S ahmad ◽  
Mohamed S Essa ◽  
Naif A Alenazi
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Gi Bleeding ◽  
Case Presentation ◽  
Pressure Necrosis ◽  
Lower Gi Bleeding ◽  
Small Intestinal ◽  
Work Up

Abstract Background Gastrointestinal stromal tumors (GISTs) is the most common primary nonepithelial neoplasms of the gastointestinal tract, mostly expressing the KIT protein determined by immunohistochemical staining for the CD117 antigen. Jejunal GISTs represent approximately 10% of all GISTs. Abdominal discomfort is the usual presentation. Jejunal GISTs may present with complications such as intestinal obstruction or hemorrhage. Gastrointestinal bleeding occurs due to pressure necrosis and ulceration of overlying mucosa, and patients who develop significant bleeding may suffer from fatigue and malaise. Small-bowel GISTs are classified based on size, and several guidelines have recommended conservative treatment for small jejunal GISTs (<2 cm).Case presentation In this report, we describe a 35-year-old male, with a jejunal GIST, who presented with an unusual massive lower GI bleeding. After resuscitation extensive work up, he was taken finally for a diagnostic laparoscopy and resection of the mass.Conclusion Small intestinal GISTs are rare and unusual to present with massive lower GI bleeding.

scholarly journals New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Pedro Boal Carvalho ◽  
Bruno Rosa ◽  
Maria João Moreira ◽  
José Cotter
Keyword(s):  
Small Bowel ◽  
Drug Use ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Decisive Role ◽  
Bleeding Risk ◽  
Obscure Gastrointestinal Bleeding ◽  
Anticoagulant Drug ◽  
The Impact

Objectives.Small bowel capsule endoscopy (SBCE) plays a decisive role in the obscure gastrointestinal bleeding (OGIB) diagnosis. Antithrombotics may increase bleeding risk in patients with preexistent lesions or through direct mucosal aggression. We aimed to correlate antithrombotics usage with lesions with bleeding potential found in SBCE.Methods.Retrospective single-center study including 274 consecutive SBCE performed over 7 years for OGIB. The lesions were classified as P0 (no bleeding potential), P1 (uncertain bleeding potential: erosions), and P2 (high bleeding potential: angioectasias, ulcers, and tumors). We assessed antiplatelet and anticoagulant drug use during the 60 days preceding SBCE.Results.One-third of the patients were under antithrombotic therapy. The diagnostic yield of SBCE for P2 lesions was 30.0%. Angioectasias (20.4%) were the most frequently observed lesions. There was a significant correlation between anticoagulant drug use and a higher incidence of P2 lesions in the small bowel (43.2% versus 26.5%; OR = 2.11,P=0.026). We found no significant correlation between antiplatelets and lesions with bleeding potential in SBCE.Conclusions.Small bowel lesions with high bleeding potential were more frequently detected when the patient was on anticoagulant drugs, resulting in a twofold risk. Antiplatelet drugs were not associated with small bowel lesions.

scholarly journals Most small bowel cancers are revealed by a complication

2015 ◽  
Vol 13 (4) ◽  
pp. 500-505 ◽  
Author(s):  
Ionut Negoi ◽  
Sorin Paun ◽  
Sorin Hostiuc ◽  
Bodgan Stoica ◽  
Ioan Tanase ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Emergency Situation ◽  
Emergency Setting ◽  
Emergency Center ◽  
Local Complication ◽  
East European ◽  
Stromal Tumors ◽  
Advanced Stages ◽  
Primary Small Bowel

ABSTRACT Objective To characterize the pattern of primary small bowel cancers in a tertiary East-European hospital. Methods A retrospective study of patients with small bowel cancers admitted to a tertiary emergency center, over the past 15 years. Results There were 57 patients with small bowel cancer, representing 0.039% of admissions and 0.059% of laparotomies. There were 37 (64.9%) men, mean age of 58 years; and 72 years for females. Out of 57 patients, 48 (84.2%) were admitted due to an emergency situation: obstruction in 21 (38.9%), perforation in 17 (31.5%), upper gastrointestinal bleeding in 8 (14.8%), and lower gastrointestinal bleeding in 2 (3.7%). There were 10 (17.5%) duodenal tumors, 21 (36.8%) jejunal tumors and 26 (45.6%) ileal tumors. The most frequent neoplasms were gastrointestinal stromal tumor in 24 patients (42.1%), adenocarcinoma in 19 (33.3%), lymphoma in 8 (14%), and carcinoids in 2 (3.5%). The prevalence of duodenal adenocarcinoma was 14.55 times greater than that of the small bowel, and the prevalence of duodenal stromal tumors was 1.818 time greater than that of the small bowel. Obstruction was the complication in adenocarcinoma in 57.9% of cases, and perforation was the major local complication (47.8%) in stromal tumors. Conclusion Primary small bowel cancers are usually diagnosed at advanced stages, and revealed by a local complication of the tumor. Their surgical management in emergency setting is associated to significant morbidity and mortality rates.

scholarly journals Identification of intestinal abnormalities in patients with active pulmonary tuberculosis using small bowel capsule endoscopy

2018 ◽  
Vol 06 (09) ◽  
pp. E1103-E1108 ◽  
Author(s):  
Miwako Saitou ◽  
Daiki Nemoto ◽  
Kenichi Utano ◽  
Tomoko Suzuki ◽  
Alan Kawarai Lefor ◽  
...  
Keyword(s):  
Small Bowel ◽  
Pulmonary Tuberculosis ◽  
Capsule Endoscopy ◽  
Primary Outcome ◽  
Ileocecal Valve ◽  
Tuberculosis Patients ◽  
Active Pulmonary Tuberculosis ◽  
Intestinal Lesions ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Small Intestinal

Abstract Background and study aims Mycobacterium tuberculosis is often detected in the feces of patients with active pulmonary tuberculosis. However, no study has examined the small intestine using small bowel capsule endoscopy (SBCE). This study aimed to investigate intestinal abnormalities in patients with active pulmonary tuberculosis. Patients and methods SBCE was performed in sputum/feces smear-positive pulmonary tuberculosis patients. From December 2013 to November 2016, 15 patients were enrolled from a dedicated tuberculous ward. The primary outcome was intestinal abnormalities identified by SBCE. Results Fourteen patients (median age 81 years, range 29 – 91; 3 female) underwent SBCE to the terminal ileum. The video was not recorded for one patient who was excluded from the analysis. Intestinal lesions, including 5 annular ulcers in 4 patients, were observed in 64 % (9/14). In subgroup analysis, prevalence tended to be higher in patients undergoing SBCE within 1 month of anti-tuberculous therapy (P = 0.051). Distribution of small intestinal lesions tended to be distal. Four of five annular ulcers were located close to the ileocecal valve. Conclusion Prevalence of intestinal lesions in patients with pulmonary tuberculosis is higher than expected before (UMIN 000017292)

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