title: Capsule endoscopy in small-bowel surveillance of patients with hereditary polyposis syndromes.
abstract: 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.
authors.affiliation: Medical Clinic I Gastroenterology, Infectious Diseases, Rheumatology, Charité-Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany. ute.guenther@charite.de
authors.forename: Ute
authors.initials: U
authors.lastname: Günther
authors.forename: Christian
authors.initials: C
authors.lastname: Bojarski
authors.forename: Heinz-Johannes
authors.initials: HJ
authors.lastname: Buhr
authors.forename: Martin
authors.initials: M
authors.lastname: Zeitz
authors.forename: Frank
authors.initials: F
authors.lastname: Heller
mesh_terms: 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