title: The usefulness of double-balloon enteroscopy in gastrointestinal stromal tumors of the small bowel with obscure gastrointestinal bleeding.
abstract: OBJECTIVE
  Gastrointestinal stromal tumors (GISTs) are the most frequently occurring mesenchymal tumors of the GI tract. Double-balloon enteroscopy (DBE) and capsule endoscopy (CE) promise the detection and accurate diagnosis of small bowel diseases in patients with obscure GI bleeding (OGIB). The aim of the present study was to analyze the clinical characteristics of small bowel GISTs and the usefulness of DBE, CE and computed tomography (CT).
  
  
  METHODS
  Among 705 cases with OGIB examined between December 2003 and January 2011, 12 (1.7%) cases of small bowel GIST were identified. We analyzed endoscopic appearance, tumor-size and location, detection rate by DBE, CE and CT and clinical course in each of these cases.
  
  
  RESULTS
  Of the 12 patients with GIST, eight were men. The mean patient age was 53.6 years. The presenting symptoms in most patients included tarry stools and/or anemia. Six patients required blood transfusions. The detection rates of DBE, CE and CT were 92%, 60% and 67%, respectively. All cases, except for one incomplete study, were identified using DBE; however, one case was not diagnosed as a tumor because of the presence of extramural growth. A pathological diagnosis of GIST was obtained using biopsies during DBE in three (45%) of seven cases. Lower detection rates were found in cases with intramural and extramural growth, larger tumors (≥35 mm) detected by CE and intraluminal growth and smaller tumors (<35 mm) detected by CT.
  
  
  CONCLUSIONS
  DBE or a combination of CE and CT are thus considered to be useful for detecting small bowel GISTs.
authors.affiliation: Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Nakatani
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Nagami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sugimori
authors.forename: Natsuhiko
authors.initials: N
authors.lastname: Kameda
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Machida
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Okazaki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yamagami
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Toshio
authors.initials: T
authors.lastname: Watanabe
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tominaga
authors.forename: Eiji
authors.initials: E
authors.lastname: Noda
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maeda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Wakasa
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
mesh_terms: D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D058582:Double-Balloon Enteroscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed