scholarly journals Cápsula endoscópica para el diagnóstico de metástasis de melanoma en intestino delgado, reporte de dos casos y revisión de la literatura

2020 ◽  
Vol 50 (1) ◽  
Author(s):  
Hugo Cedron Cheng ◽  
Josué Aliaga Ramos
Keyword(s):  
Gastrointestinal Tract ◽  
Malignant Melanoma ◽  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Deficiency Anemia ◽  
Bowel Involvement ◽  
History Of

Malignant melanoma is the neoplasm that most frequently produces metastasis at the gastrointestinal tract. Metastatic lesions can be found in the small bowel in 50 to 60% of the necropsies of patients who die due to malignant melanoma; however, the diagnosis of metastasis in vivo is achieved in less than 10% of patients with this clinical entity. The capsule endoscopy is considered an excellent non-invasive diagnostic method for the evaluation of the small bowel in this group of patients. All patients with melanoma history and gastrointestinal tract hemorrhage, iron deficiency anemia, abdominal pain and / or unexplained weight loss should perform an capsule endoscopy to rule out small bowel involvement. We present two patients with cutaneous melanoma with apparent remission who develop iron-deficiency anemia, without a history of evident gastrointestinal bleeding with negative endoscopic examinations and capsule endoscopy findings of intestinal metastasis due to melanoma.

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

Endoscopy ◽  
2018 ◽  
Vol 51 (05) ◽  
pp. 409-418 ◽  
Author(s):  
Hey-Long Ching ◽  
Melissa F. Hale ◽  
Matthew Kurien ◽  
Jennifer A. Campbell ◽  
Stefania Chetcuti Zammit ◽  
...  
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Deficiency Anemia ◽  
Gi Tract ◽  
Upper Gi ◽  
Upper Gi Tract ◽  
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 Small Bowel Radiographic Imaging is Not Useful for Isolated Iron-Deficiency Anemia

2019 ◽  
Author(s):  
Richard Hae ◽  
Sanjay Murthy
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Radiographic Imaging ◽  
Ct Enterography ◽  
Bowel Imaging ◽  
Small Bowel Imaging ◽  
New Onset

Abstract Background Iron deficiency anemia in the absence of overt bleeding can result from chronic occult blood loss from the gastrointestinal tract. When esophagogastroduodenoscopy (EGD) and colonoscopy fail to demonstrate clinically significant lesions (CSLs), practitioners often consider small bowel investigations, such as CT enterography and video capsule endoscopy. Although most society guidelines recommend further investigations to evaluate the small bowel, few studies have evaluated the utility of small bowel radiographic imaging in this setting.Methods This is a retrospective cross-sectional study investigating the rates and types of CSLs identified during EGD, colonoscopy and small bowel imaging among individuals over age 50 who were referred for new-onset iron deficiency anemia without overt bleeding. Data was collected on 334 consecutive patients who underwent colonoscopy with or without EGD to evaluate new-onset iron deficiency anemia at The Ottawa Hospital from January 1, 2010 to March 30, 2012. We evaluated the frequency of CSLs among all patients and those who further underwent small bowel radiographic imaging.Results Of the 332 individuals who underwent colonoscopy, 42 (12.7%) were found to have a CSL, with 37 of these being malignancy or high-grade adenomas. Of the 258 individuals who also underwent EGD, 49 (19.0%) had CSLs, including 11 vascular ectasias, 15 peptic ulcer disease, 8 celiac disease, 8 severe erosive esophagitis, and 9 esophageal varices. Of 243 patients who did not have any CSLs identified on colonoscopy +/- EGD, 75 underwent subsequent small bowel imaging, and 9 patients underwent small bowel imaging despite having a CSL found on endoscopy. A total of 84 patients underwent subsequent small bowel imaging (68 CT enterography, 13 small bowel follow-through, one MR enterography, one CT enteroclysis, and one push enteroscopy). In these 84 patients, only one relevant CSL was found (inflammatory bowel disease).Conclusions Upper and lower endoscopy are valuable tools for diagnosing gastrointestinal tract lesions in individuals over the age of 50 with newly diagnosed iron deficiency anemia in the absence of overt bleeding. CT enterography and small bowel follow-through have limited utility in this setting.

scholarly journals Single Cavernous Hemangioma of the Small Bowel Diagnosed by Using Capsule Endoscopy in a Child with Chronic Iron-Deficiency Anemia

2015 ◽  
Vol 48 (4) ◽  
pp. 340 ◽  
Author(s):  
Soo Jin Bae ◽  
Geol Hwang ◽  
Hyun Sik Kang ◽  
Hyun Joo Song ◽  
Weon Young Chang ◽  
...  
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Cavernous Hemangioma ◽  
Deficiency Anemia

Diagnostic yield of small-bowel capsule endoscopy in patients with iron-deficiency anemia: a systematic review

2012 ◽  
Vol 76 (5) ◽  
pp. 983-992 ◽  
Author(s):  
Anastasios Koulaouzidis ◽  
Emanuele Rondonotti ◽  
Andry Giannakou ◽  
John N. Plevris
Keyword(s):  
Systematic Review ◽  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Deficiency Anemia

Iron deficiency anemia despite effective gluten-free diet in celiac disease: Diagnostic role of small bowel capsule endoscopy

2017 ◽  
Vol 49 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Konstantinos Efthymakis ◽  
Angelo Milano ◽  
Francesco Laterza ◽  
Mariaelena Serio ◽  
Matteo Neri
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Gluten Free Diet ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Diagnostic Role

scholarly journals IMPACT OF SMALL BOWEL CAPSULE ENDOSCOPY IN IRON DEFICIENCY ANEMIA: INFLUENCE OF PATIENT’SAGE ON DIAGNOSTIC YIELD

2018 ◽  
Vol 55 (3) ◽  
pp. 242-246 ◽  
Author(s):  
Sofia XAVIER ◽  
Joana MAGALHÃES ◽  
Bruno ROSA ◽  
Maria João MOREIRA ◽  
José COTTER
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Vascular Lesions ◽  
Deficiency Anemia ◽  
Age Group ◽  
Single Center Study ◽  
Significant Pathology

ABSTRACT BACKGROUND: Iron deficiency anemia remains one of the main indications to perform small bowel capsule endoscopy. Literature suggests that diagnostic yield is influenced by patient’s age but with conflicting results regarding age cutoff. OBJECTIVE: We aimed to clarify the differences in diagnostic yield and incidence of specific findings according to age. METHODS: Retrospective single-center study including 118 patients performing small bowel capsule endoscopy in the study of iron deficiency anemia. Videos were reviewed and small bowel findings that may account for anemia were reported. Incomplete examinations were excluded. Findings were compared between patients ≤60 and >60 years. RESULTS: Patients had a mean age of 58 years old (SD ±17.9) with 69.5% females (n=82). The overall diagnostic yield was 49% (58/118), being higher among patients >60 years (36/60, diagnostic yield 60%) than those ≤60 years (20/58, diagnostic yield 34%), (P<0.01). Angioectasias were more frequent in patients >60 years (45% vs 9%, P<0.01). Patients ≤60 years presented more frequently significant inflammation (Lewis score >135 in 10.3% vs 1.7%, P<0.05) and other non-vascular lesions (24% vs 10%, P=0.04). CONCLUSION: In our cohort small bowel capsule endoscopy diagnosed clinically relevant findings in the setting of iron deficiency anemia in almost half the patients. Diagnostic yield was higher in patients older than 60 years (60%), with vascular lesions being more frequent in this age group. Despite the lower diagnostic yield in patients ≤60 years, significant pathology was also found in this age group, mainly of inflammatory type.

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