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

2015 ◽  
Vol 28 (4) ◽  
pp. 448 ◽  
Author(s):  
Hélder Cardoso ◽  
João Tiago Rodrigues ◽  
Margarida Marques ◽  
Armando Ribeiro ◽  
Filipe Vilas-Boas ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Imaging Techniques ◽  
Bowel Cancer ◽  
First Year ◽  
Small Bowel Tumors ◽  
Small Bowel Cancer ◽  
Endoscopic Techniques ◽  
High Degree ◽  
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 P096 Which patients with known Crohn’s disease after an ileo-colonoscopy will benefit most from small bowel capsule endoscopy?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S193-S194
Author(s):  
N Viazis ◽  
A Mountaki ◽  
K Koustenis ◽  
C Veretanos ◽  
K Arvanitis ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Terminal Ileum ◽  
Imaging Techniques ◽  
Clinical Manifestations ◽  
Endoscopic Techniques ◽  
Proximal Small Bowel ◽  
Number Of Patients

Abstract Background Ileo-colonoscopy with biopsies is considered the gold standard for the diagnosis and management of Crohn’s disease (CD). In contrast, the role of small bowel capsule endoscopy (SBCE) is limited currently in cases where ileo-colonoscopy and imaging techniques raise doubts on the diagnosis or cannot explain certain clinical manifestations of Crohn’s disease. The aim of our study was to determine whether there are patients with endoscopically confirmed established CD who could get additional benefit by SBCE. Methods Retrospective analysis of prospectively collected data from 6301 patients subjected to SBCE in our department from 1st March 2003 to 18th February 2021. Patients with CD diagnosed by ileo-colonoscopy or total colonoscopy only (because the ileo-caecal valve could not be intubated) prior to SBCE were included in the study and biopsies. SBCE had been performed only in patients who lacked any clinical and/or imaging (CT/MRE) evidence of bowel obstruction. The presence and extent of mucosal lesions, namely local and/or diffuse erythema, erosions and ulcers (aphthous, superficial and/or deep) throughout the small intestine, which may be difficult to identify by traditional imaging, could either explain clinical manifestations unrelated to the findings of colonoscopy or led onto reassessment of applied treatments were sought by SBCE. Results The study sample consisted of 1002 patients (males/females: 511/491, mean age ± SD: 52.6±27.3). Among these, CD had been diagnosed with colonoscopy (and not ileo-colonoscopy) in 293 (29.2%) subjects and small bowel involvement was seen in 104 (35.5%) patients. The vast majority of these patients had lesions only in the terminal ileum (n=81, 77.8%), while the remaining patients (n=23, 22.2%) had additional lesions in more proximal parts of the small bowel. Among the 709 (70.8%) patients in whom CD had been diagnosed by ileo-colonoscopy, lesions in the terminal ileum were found in 407 (57.4 %) patients; SBCE revealed more proximal lesions in 104 patients (25.5%). In the remaining 307 patients (43.3%) in whom ileo-colonoscopy did not reveal terminal ileum involvement, more proximal small bowel lesions were seen in 35 (11.4%) patients. These lesions were mainly apthoid ulcers or larger ulcers, findings that led to a change in therapeutic management in 17 patients (48.6%). Conclusion SBCE identifies more proximal small bowel lesions in a substantial number of patients with CD established by traditional endoscopic techniques. When these lesions are more severe and extensive they may lead onto re-evaluation of the personalized therapeutic strategies.

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

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

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

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

scholarly journals Role of Mucosal Protrusion Angle in Discriminating Between True and False Masses of the Small Bowel on Video Capsule Endoscopy

2019 ◽  
Vol 8 (4) ◽  
pp. 418 ◽  
Author(s):  
May Min ◽  
Michael Noujaim ◽  
Jonathan Green ◽  
Christopher Schlieve ◽  
Aditya Vaze ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Acute Angle ◽  
Video Capsule Endoscopy ◽  
Small Bowel Tumors ◽  
Exact Test ◽  
Endoscopic Techniques ◽  
Extrinsic Compression ◽  
Low Incidence

The diagnosis of small-bowel tumors is challenging due to their low incidence, nonspecific presentation, and limitations of traditional endoscopic techniques. In our study, we examined the utility of the mucosal protrusion angle in differentiating between true submucosal masses and bulges of the small bowel on video capsule endoscopy. We retrospectively reviewed video capsule endoscopies of 34 patients who had suspected small-bowel lesions between 2002 and 2017. Mucosal protrusion angles were defined as the angle between the small-bowel protruding lesion and surrounding mucosa and were measured using a protractor placed on a computer screen. We found that 25 patients were found to have true submucosal masses based on pathology and 9 patients had innocent bulges due to extrinsic compression. True submucosal masses had an average measured protrusion angle of 45.7 degrees ± 20.8 whereas innocent bulges had an average protrusion angle of 108.6 degrees ± 16.3 (p < 0.0001; unpaired t-test). Acute angle of protrusion accurately discriminated between true submucosal masses and extrinsic compression bulges on Fisher’s exact test (p = 0.0001). Our findings suggest that mucosal protrusion angle is a simple and useful tool for differentiating between true masses and innocent bulges of the small bowel.

SMALL BOWEL CAPSULE ENDOSCOPY IN THE WEST OF IRELAND: A CLOSER LOOK AT THE FIRST YEAR

2020 ◽  
Author(s):  
H O’Donovan ◽  
H Yousuf ◽  
D Gallagher ◽  
C Goulding
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
First Year ◽  
The West ◽  
West Of Ireland

scholarly journals Management of Advanced Small Bowel Cancer

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

Small Bowel Tumors Detected By Video Capsule Endoscopy (VCE): Preliminary Data from the ECEG (European Capsule Endoscopy Group) Database

2007 ◽  
Vol 65 (5) ◽  
pp. AB90 ◽  
Author(s):  
Emanuele Rondonotti ◽  
Marco Pennazio ◽  
Italian Club for Capsule Endoscopy ◽  
European Capsule Endoscopy Group ◽  
Iberian Group of Capsule Endoscopy
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Preliminary Data ◽  
Video Capsule Endoscopy ◽  
Small Bowel Tumors

Video Capsule Endoscopy and Deep Enteroscopy

2017 ◽  
Author(s):  
Neil Marya ◽  
Veronica Baptista ◽  
Anupam Singh ◽  
Joseph Charpentier ◽  
David Cave
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Carcinoid Tumor ◽  
Capsule Endoscopy ◽  
Crohn Disease ◽  
Malignant Tumors ◽  
Video Capsule Endoscopy ◽  
X Rays ◽  
Small Bowel Tumors ◽  
Peutz Jeghers Syndrome

Until 2001, the nonsurgical evaluation of the small intestine was largely limited to the use of radiologic imaging (e.g., small bowel follow-through or enteroclysis). With the now widespread availability of video capsule endoscopy and deep enteroscopy since 2001, we are now able to visualize the length and most of the mucosa of the small intestine and manage small bowel lesions that were previously inaccessible except by surgical intervention. This review serves as an overview for these two procedures, detailing the indications and contraindications, proper timing of the procedure, technical aspects of the devices themselves, possible complications, and outcomes. Figures show endoscopic images that demonstrate multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, severe mucosal scalloping, small bowel carcinoid tumor, small bowel polyp associated with Peutz-Jeghers syndrome, and nonsteroidal antiinflammatory drug enteropathy; serial x-rays of a patient with a patency capsule retained inside the small intestine; a computer image showing the distribution of small bowel tumors; and a pie chart displaying the breakdown of the distribution of benign and malignant tumors that can be found in the small intestine. Videos show multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, small bowel carcinoid tumor, and small bowel polyp associated with Peutz-Jeghers syndrome. This review contains 10 highly rendered figures, 5 videos, and 50 references.

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