title: Enteroscopic and radiologic diagnoses, treatment, and prognoses of small-bowel tumors.
abstract: BACKGROUND
  Small-bowel tumors (SBTs) represent a diagnostic challenge.
  
  
  OBJECTIVE
  To evaluate the usefulness of contrast-enhanced CT (CECT), fluoroscopic enteroclysis (FE), videocapsule endoscopy (VCE), and double-balloon endoscopy (DBE) and the outcome after treatment.
  
  
  METHODS
  Single-center, retrospective study.
  
  
  METHODS
  Tertiary-care referral hospital.
  
  
  METHODS
  Between June 2003 and May 2011, 159 consecutive patients with SBTs (93 malignant and 66 benign) were enrolled.
  
  
  METHODS
  Comparison of diagnostic yields among CECT, FE, VCE, and DBE and the prognosis.
  
  
  RESULTS
  CECT and FE had significantly lower diagnostic yields of SBTs ≤ 10 mm, but VCE and DBE had high yields of SBTs regardless of size. CECT had a significantly lower diagnostic yield of epithelial tumors compared with subepithelial tumors. When stratified by the site, the diagnostic yield of VCE for SBTs located only in the distal duodenum/the proximal jejunum (73%) was significantly lower than that for SBTs located in other areas (90%). Comparisons among the 4 methods revealed that VCE and DBE had significantly higher diagnostic yields than CECT, and DBE had significantly higher diagnostic yields than VCE, but a combination of CECT and VCE had a diagnostic yield similar to that of DBE. The histologic diagnostic yield of SBTs by DBE was 92%, and 25% of SBTs were enteroscopically treated. Metastatic tumors had the poorest overall survival, followed by adenocarcinomas and malignant lymphomas.
  
  
  CONCLUSIONS
  Retrospective comparative study.
  
  
  CONCLUSIONS
  For the detection of SBTs, a combination screening method by using VCE and CECT is recommended. DBE is useful for histologic diagnosis and endoscopic treatment.
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Wataru
authors: W
authors: Honda
authors: Naoki
authors: N
authors: Ohmiya
authors: Yoshiki
authors: Y
authors: Hirooka
authors: Masanao
authors: M
authors: Nakamura
authors: Ryoji
authors: R
authors: Miyahara
authors: Eizaburo
authors: E
authors: Ohno
authors: Hiroki
authors: H
authors: Kawashima
authors: Akihiro
authors: A
authors: Itoh
authors: Osamu
authors: O
authors: Watanabe
authors: Takafumi
authors: T
authors: Ando
authors: Hidemi
authors: H
authors: Goto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D003131:Combined Modality Therapy; D058582:Double-Balloon Enteroscopy; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D007580:Jejunal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult