Capsule endoscopy in small-bowel surveillance of patients with hereditary polyposis syndromes.
OBJECTIVE
Familial adenomatous polyposis (FAP) and Peutz-Jeghers syndrome (PJS) are hereditary polyposis syndromes with a high risk for benign small-bowel polyps and cancer. The aim of this study was to assess the prevalence of small-bowel polyps beyond the duodenum in patients with FAP and PJS and to examine the clinical value and the optimal interval of capsule endoscopy (CE) for the surveillance of small-bowel polyps in patients with FAP.


METHODS
Between 2002 and 2009, standard gastroscopy, duodenoscopy, and CE were performed on 19 consecutive patients with hereditary polyposis syndromes (FAP n=15; PJS n=4). The number, size, and location of polyps detected by CE were assessed. Five FAP patients had repeated CEs in intervals of 2-7 years.


RESULTS
In 13 of the 15 (87%) FAP patients, small-bowel polyps were detected by CE ranging from estimated <5 mm to >10 mm in size. Thereof, in four patients, medium-sized (5-10 mm) or large-sized (>10 mm) polyps were seen-all of them located in the proximal jejunum. In three FAP patients with repeated CEs, the latest CE displayed medium- and large-sized polyps in the proximal jejunum, whereas previous CEs had detected only small-sized (<5 mm) polyps. In three of the four PJS patients, large-sized small-bowel polyps were visualized by CE which could then be removed by double-balloon enteroscopy (DBE) or surgical resection.


CONCLUSIONS
CE is an effective and safe method for small-bowel surveillance in FAP and PJS.
Günther
Ute
U
Medical Clinic I Gastroenterology, Infectious Diseases, Rheumatology, Charité-Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany. ute.guenther@charite.de
Bojarski
Christian
C
Buhr
Heinz-Johannes
HJ
Zeitz
Martin
M
Heller
Frank
F
D000236:Adenoma / Q000145:classification / Q000175:diagnosis; D011125:Adenomatous Polyposis Coli / Q000175:diagnosis*; D053704:Capsule Endoscopy; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis*; D013577:Syndrome