scholarly journals Small Bowel Malignancies in Patients Undergoing Capsule Endoscopy for Iron Deficiency Anemia

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 91
Author(s):  
Su Hwan Kim ◽  
Ji Won Kim

Small bowel malignancies are rare and usually asymptomatic or symptoms are nonspecific. Therefore, small bowel tumors are difficult to diagnose. In patients with iron deficiency anemia (IDA) who have negative bidirectional endoscopy results, the small bowel may be considered the source of bleeding. However, in asymptomatic IDA patients with negative bidirectional endoscopy results, evidence supporting the routine use of capsule endoscopy (CE) is insufficient. CE can be considered in selected patients with recurrent or persistent IDA. The frequency of small bowel malignancies is low in patients undergoing CE for IDA, but the usefulness of CE for the diagnosis of small bowel malignancies in younger age groups with IDA has been reported. For patients with risk factors for small bowel malignancy, investigation of the small bowel should be considered. Efforts should be made to prevent adverse events, such as capsule retention or capsule aspiration, through meticulous history taking and endoscopic capsule delivery as necessary.

Endoscopy ◽  
2018 ◽  
Vol 51 (05) ◽  
pp. 409-418 ◽  
Author(s):  
Hey-Long Ching ◽  
Melissa F. Hale ◽  
Matthew Kurien ◽  
Jennifer A. Campbell ◽  
Stefania Chetcuti Zammit ◽  
...  

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.


2015 ◽  
Vol 48 (4) ◽  
pp. 340 ◽  
Author(s):  
Soo Jin Bae ◽  
Geol Hwang ◽  
Hyun Sik Kang ◽  
Hyun Joo Song ◽  
Weon Young Chang ◽  
...  

2012 ◽  
Vol 76 (5) ◽  
pp. 983-992 ◽  
Author(s):  
Anastasios Koulaouzidis ◽  
Emanuele Rondonotti ◽  
Andry Giannakou ◽  
John N. Plevris

2017 ◽  
Vol 49 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Konstantinos Efthymakis ◽  
Angelo Milano ◽  
Francesco Laterza ◽  
Mariaelena Serio ◽  
Matteo Neri

2016 ◽  
Vol 11 (4) ◽  
pp. 372-375
Author(s):  
Catalina DIACONU ◽  
◽  
Madalina ILIE ◽  
Daniela TABACELIA ◽  
Ecaterina RINJA ◽  
...  

Background: Iron deficiency anemia is the most common cause of anemia worldwide. The differential diagnosis of this entity remains one of the most encountered problems: from thalassemia, neoplasia, malabsorbtion syndrome to chronic kidney disease under hemodialysis. Case report: This case report describes clinical and paraclinical features of a 75-year-old patient with multiple comorbidities and iron deficiency anemia. We emphasize on the importance of endoscopic videocapsule examination for the accurate diagnosis of iron deficiency anemia when other methods fail (endoscopy and colonoscopy), thus revealing the source of bleeding in a small bowel benign polyp. Thus, tumors of the small intestine present as a unique challenging diagnosis. Conclusion: Endoscopic videocapsule, even if expensive, should remain an important tool in the diagnosis of iron deficiency anemia with normal upper GI endoscopy and colonoscopy. Small bowel tumors are seldom considered as a diagnostic hypothesis, but should not be overlooked, especially when alarm symptoms are present (weight loss, melena, hematochesia).


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