title: Characteristics of small bowel tumors detected by double balloon endoscopy.
abstract: BACKGROUND
  A few reports suggest that the emergence of double balloon endoscopy (DBE) has likely changed the clinical picture of small bowel tumors (SBTs).
  
  
  OBJECTIVE
  To further clarify the characteristics of SBTs detected by DBE.
  
  
  METHODS
  A retrospective chart review was conducted in 227 patients who had undergone DBE.
  
  
  RESULTS
  The SBT group contained more symptomatic patients than the non-SBT group (90% vs. 49%, P<0.0005) with a significantly higher rate of gastrointestinal symptoms at presentation (72% vs. 33%, P<0.005). Twenty patients (8.8%) were eventually diagnosed with SBT, and their indications for DBE were obscure gastrointestinal bleeding (n=5), abdominal pain (n=5), abdominal fullness (n=5), vomiting (n=2), and diarrhea (n=1). Tumors were located in the jejunum in 14 patients (70%) and in the ileum in 6 (30%). A final histological diagnosis was assigned to all 20 patients: primary adenocarcinoma (n=8, 40%), malignant lymphoma (n=5, 25%), metastatic cancer (n=4, 20%), gastrointestinal stromal tumor (n=1, 5%), carcinoid tumor (n=1, 5%) and inflammatory fibroid polyp (n=1, 5%). Stenosis or ulceration were the most frequently observed endoscopic findings (n=13, 65%). All primary adenocarcinomas and three of four (75%) metastatic cancers showed stenosis or ulceration. Three of five (60%) malignant lymphomas showed multiple lymphomatous polyps. All patients but one underwent surgical resection or chemotherapy or both.
  
  
  CONCLUSIONS
  DBE is a safe and useful procedure that enables a precise diagnosis of SBTs.
authors: Internal Medicine, Saiseikai Imabari Hospital, and Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine, Ehime, Japan.
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authors: Imaoka
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authors: Higaki
authors: Teru
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authors: Kumagi
authors: Jirou
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authors: Miyaike
authors: Masaki
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authors: Ohmoto
authors: Kazuhiko
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authors: Yamauchi
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authors: Matsuura
authors: Morikazu
authors: M
authors: Onji
authors: Masakichi
authors: M
authors: Umeda
authors: Norio
authors: N
authors: Horiike
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