title: Double-balloon enteroscopy and small bowel tumors: a South-European single-center experience.
abstract: Small bowel tumors are rare, accounting for 1-2% of all gastrointestinal neoplasms. We sought to determine the diagnostic and therapeutic impact of double-balloon enteroscopy (DBE) in patients with small bowel tumors. Between January 2005 and March 2008, 78 patients underwent 96 DBE. All nine patients (seven males; mean age 68 +/- 11.3 years) with small bowel tumors were retrospectively reviewed. Clinical presentation was: mid-gastrointestinal bleeding or iron-deficient anemia (55.6%); abdominal pain (22.2%); nausea/vomiting and abdominal distension (22.2%). Five patients had abnormal findings in previous capsule endoscopy and four in previous radiologic examinations. Route of insertion was exclusively oral and abnormal lesions were detected in all patients (jejunum 8; ileum 1). Biopsies were taken in seven patients and provided definitive histological diagnosis in all except one. There were no complications of DBE. Surgical resection took place in eight patients. Final histologic diagnosis were: primary carcinoma (33.3%), gastrointestinal stromal tumor (GIST) (33.3%), malignant lymphoma (22.2%), and carcinoid tumor (11.1%). Mean follow-up time was 15.4 +/- 12.7 months (range 2-34 months). Six patients were submitted to chemotherapy. Two patients died. Small bowel tumors are common in patients submitted to DBE. Given its safety and diagnostic capabilities, DBE should be considered the gold-standard method in the study of these neoplasms.
authors.affiliation: Gastroenterology Department, Coimbra University Hospital, Portugal Praceta Mota Pinto and Av Bissaya Barreto, 3000-075, Coimbra, Portugal. nunoperesalmeida@gmail.com
authors.forename: Nuno
authors.initials: N
authors.lastname: Almeida
authors.forename: Pedro
authors.initials: P
authors.lastname: Figueiredo
authors.forename: Sandra
authors.initials: S
authors.lastname: Lopes
authors.forename: Hermano
authors.initials: H
authors.lastname: Gouveia
authors.forename: Maximino C
authors.initials: MC
authors.lastname: Leitão
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D002430:Cecal Neoplasms / Q000150:complications / Q000175:diagnosis*; D003251:Constriction, Pathologic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007580:Jejunal Neoplasms / Q000150:complications / Q000175:diagnosis*; D007583:Jejunum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012189:Retrospective Studies; D055815:Young Adult