Proposed scoring system to determine small bowel mass lesions using capsule endoscopy.
OBJECTIVE
Capsule endoscopy is a highly sensitive method for the detection of small bowel lesions. False-positive findings are important confounding factors. This study reports on a scoring system for evaluating the role of capsule endoscopy in small bowel tumors.


METHODS
Ten men and two women (age, 23-79 years) with suspected small bowel tumors were included from 120 patients referred for capsule endoscopy between March 2004 and March 2008. The indications were gastrointestinal bleeding (n = 9), melanoma workup (n = 1), physical checkup (n = 1), and iron deficiency anemia (n = 1). The proposed tumor score was composed of five components: bleeding, mucosal disruption, an irregular surface, color, and white villi. These can be scored for probability of mass lesions seen at capsule endoscopy. Small bowel mass lesions were probably present in those with a score of >or= 4, and a score of <or= 2 indicated a low probability of a small bowel mass lesion.


RESULTS
Capsule endoscopy showed probable small bowel mass lesions in six patients, and a low lesion probability in the other six. Capsule endoscopy showed that new lesions were not detected by esophagogastroduodenoscopy or colonoscopy. All six patients with probable small bowel tumors were found to have pathological findings upon capsule endoscopy: two with lymphangioma, and one each with ileal ectopic pancreas, with melanoma metastasis, gastrointestinal lymphoma, and gastrointestinal stromal tumor.


CONCLUSIONS
Capsule endoscopy may detect small bowel tumors more reliably by using the scoring system outlined. It should be considered in suspected cases of small bowel tumor.
Shyung
Li-Rung
LR
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
Lin
Shee-Chan
SC
Shih
Shou-Chuan
SC
Chang
Wen-Hsiung
WH
Chu
Cheng-Hsin
CH
Wang
Tsang-En
TE
D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies