Small bowel tumors in patients undergoing capsule endoscopy: a single center experience.
OBJECTIVE
Small bowel tumors (SBTs) are rare, accounting for 1-3% of all gastrointestinal malignancies. Since the introduction of capsule endoscopy (CE), several studies have suggested that their frequency may be substantially higher. The present study is aimed at evaluating the prevalence, clinical presentation, laboratory parameters, endoscopic appearance, and diagnostic work-up of SBTs in patients undergoing CE in a single referral center.


METHODS
During 2003-2009, 102 patients underwent CE. For each patient with lesions suggesting SBT at CE, with subsequent diagnostic/ therapeutic work-up leading to histological confirmation, we registered: clinical presentation, hemoglobin level, small bowel follow-through, red blood cells scintigraphy, CT-enterography, enteroscopy, histological confirmation and management.


RESULTS
SBTs were detected in 5 patients (mean age 55.2+/-15.8 years) of 102 undergoing CE (4.9%). The main indication for CE was obscure gastrointestinal bleeding, occult or overt. All patients had undergone, before CE, at least one procedure evaluating the small bowel after negative upper endoscopy and colonoscopy. All patients had iron-deficiency anemia, three had abdominal pain, two had episodes of nausea /vomiting and one had diarrhoea and abdominal distension. The main SBT type was gastrointestinal stromal tumor. After CE, 3 patients underwent single-balloon enteroscopy; surgery was performed in all patients. Mean follow-up time was 19+/-17 (range 2-36) months; one patient died during follow-up. No retention of capsule occurred.


CONCLUSIONS
CE could be used as first choice for diagnostic investigation in patients suspected to have SBTs.
Trifan
Anca
A
Institute of Gastroenterology and Hepatology, Gr. T. Popa University of Medicine and Pharmacy, Bd. Independentei no. 1, Iasi, Romania. ancatrifan@yahoo.com
Singeap
Ana-Maria
AM
Cojocariu
Camelia
C
Sfarti
Catalin
C
Stanciu
Carol
C
D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D013505:Digestive System Surgical Procedures; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007414:Intestinal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome