Skip to main content

Advertisement

Log in

Incidence of tumoral pathology according to study using capsule endoscopy for patients with obscure gastrointestinal bleeding

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Capsule endoscopy has involved a significant advance in techniques for imaging of the small bowel. Its most frequent indication is for studying patients with obscure gastrointestinal bleeding (OGIB). Small bowel tumors are infrequent, representing only 1% to 3% of all malignant gastrointestinal tumors. This study aimed to assess retrospectively the occurrence and characteristics of tumoral pathology diagnosed by means of capsule endoscopy in patients with OGIB.

Methods

A retrospective review analyzed the first 320 patients submitted to capsule endoscopy because of OGIB (166 with obscure overt bleeding and 154 with obscure occult bleeding) at a single center. The patients with a tumor diagnosis were analyzed in terms of incidence, characteristics, and treatment of OGIB pathology.

Results

Tumor incidence was of 7.18% (23/320), with 65.2% of the cases supported with histologic confirmation (15/23). Obscure overt bleeding was the most frequent form of presentation, with the jejunum as the most frequent location (65.2%). For 16 patients, an intervention was conducted with a healing intent. Capsule endoscopy allowed the diagnosis of two cecal adenocarcinomas missed by colonoscopy.

Conclusions

Small bowel tumors are not an infrequent cause of OGIB. Capsule endoscopy, even if it does not allow determination of the benign or malignant nature or the histologic type of the tumor, is a useful tool for the diagnosis and early management of these tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.

Similar content being viewed by others

References

  1. Ashley SW, Wells SA Jr (1988) Tumors of the small intestine (review). Semin Oncol 15: 116–128

    PubMed  CAS  Google Scholar 

  2. Brophy C, Cahow CE (1989) Primary small bowel malignant tumors: unrecognized until emergent laparotomy. Am Surg 55: 408–412

    PubMed  CAS  Google Scholar 

  3. Crosby JA, Catton CN, Davis A, Couture J, O’Sullivan B, Kandel R, Swallow CJ (2001) Malignant gastrointestinal stromal tumors of the small intestine: a review of 50 cases from a prospective database. Ann Surg Oncol 8: 50–59

    Article  PubMed  CAS  Google Scholar 

  4. Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J (2004) Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients. Cancer 101: 518–526

    Article  PubMed  Google Scholar 

  5. Desa L, Bridger J, Grace P, Krausz T, Spencer J (1991) Primary jejunoileal tumors: a review of 45 cases. World J Surg 15: 81–87

    Article  PubMed  CAS  Google Scholar 

  6. DiSario JA, Burt RW, Vargas H, Mc Whorter WP (1994) Small bowel cancer: epidemiological and clinical characteristics from a population-based registry. Am J Gastroenterol 89: 699–701

    PubMed  CAS  Google Scholar 

  7. Ell C, Remke S, May A, Helou L, Henrich R, Mayer G (2002) The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy 34: 685–689

    Article  PubMed  CAS  Google Scholar 

  8. Kituyakara T, Selby W (2005) Non–small bowel lesions detected by capsule endoscopy in patients with obscure GI bleeding. Gastrointest Endosc 62: 234–238

    Article  Google Scholar 

  9. Lewis BS, Eisen GM, Friedman S (2005) A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy 37: 960–965

    Article  PubMed  CAS  Google Scholar 

  10. Maieron A, Hubner D, Blaha B, Deutsch C, Schickmair T, Ziachehabi A, Kerstan E, Knoflach P, Schoefl R (2004) Multicenter retrospective evaluation of capsule endoscopy in clinical routine. Endoscopy 36: 864–868

    Article  PubMed  CAS  Google Scholar 

  11. Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, De Franchis R (2004) Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 126: 643–653

    Article  PubMed  Google Scholar 

  12. Saurin JC, Delvaux M, Gaudin JL, Fassler I, Villarejo J, Vahedi K, Bitoun A, Canard JM, Souquet JC, Ponchon T, Florent C, Gay G (2003) Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push enteroscopy. Endoscopy 35: 576–584

    Article  PubMed  Google Scholar 

  13. Selby W (2004) Can clinical features predict the likelihood of finding abnormalities when using capsule endoscopy in patients with GI bleeding of obscure origin? Gastrointest Endosc 59: 782–787

    Article  PubMed  Google Scholar 

  14. Serour F, Dona G, Birkenfeld S, Balassiano M, Krispin M (1992) Primary neoplasms of the small bowel. J Surg Oncol 49: 29–34

    Article  PubMed  CAS  Google Scholar 

  15. Talamonti MS, Goetz LH, Rao S, Joel RJ (2002) Primary cancers of the small bowel. Arch Surg 137: 564–571

    Article  PubMed  Google Scholar 

  16. Triester SL, Leighton JA, Leontiadis GI, Gurudu SR, Fleischer DE, Hara AK, Heigh RI, Shiff AD, Sharma VK (2005) A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 100: 2407–2418

    Article  PubMed  Google Scholar 

  17. Viazis N, Papaxoinis K, Theodoropoulus I, Sgouros S, Vlachogiannakos J, Pipis P, Markoglou C, Avgerinos A (2005) Impact of capsule endoscopy in obscure small-bowel bleeding: defining strict criteria for a favorable outcome. Gastrointest Endosc 62: 717–722

    Article  PubMed  Google Scholar 

  18. Zuckerman GR, Prakash C, Askin MP, Lewis BS (2000) AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology 118: 201–221

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Estévez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Estévez, E., González-Conde, B., Vázquez-Iglesias, J.L. et al. Incidence of tumoral pathology according to study using capsule endoscopy for patients with obscure gastrointestinal bleeding. Surg Endosc 21, 1776–1780 (2007). https://doi.org/10.1007/s00464-007-9242-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-007-9242-8

Keywords

Navigation