Small bowel tumors: A digestive endoscopy society of Taiwan (DEST) multicenter enteroscopy-based epidemiologic study

Chung, Chen‐Shuan; Tai, Chi‐Ming; Huang, Tien‐Yu; Chang, Chen‐Wang; Chen, Kuan‐Chih; Tseng, Chao‐Ming; Wang, Horng‐Yuan; Chu, Cheng‐Hsin; Wu, Jiann‐Ming; Chen, Yun; Wang, Hsiu-Po

doi:10.1016/j.jfma.2017.09.003

Cited by 22 publications

(22 citation statements)

References 15 publications

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“…Approximately three quarters of epithelial tumors were found in the duodenum or jejunum, and all were observed as solitary lesions (Table 2). Previous studies using BAE reported that primary small intestinal adenocarcinoma was located mainly in the duodenum or jejunum with a range of 77.8%–100.0%[6,7,11-14]. Primary small intestinal adenocarcinoma was reported as a solitary lesion in several studies[6,7,12-14], which was consistent with our results, whereas metastatic tumors were sometimes observed as multiple lesions[11,15].…”

Section: Discussionsupporting

confidence: 91%

“…Previous studies using BAE reported that primary small intestinal adenocarcinoma was located mainly in the duodenum or jejunum with a range of 77.8%–100.0%[6,7,11-14]. Primary small intestinal adenocarcinoma was reported as a solitary lesion in several studies[6,7,12-14], which was consistent with our results, whereas metastatic tumors were sometimes observed as multiple lesions[11,15]. In our classification, primary and metastatic tumors were classified into the same groups; however, it might be better to distinguish between metastatic and primary tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, BAE enables direct observation of these small intestinal lesions, and also permits biopsy and endoscopic therapy, such as stent placement and endoscopic tattooing for subsequent surgical therapy[5,6]. A previous study reported the incidence of small intestinal tumors detected by BAE[6,7]; however, the endoscopic characteristics of small intestinal tumors have been reported only in a limited number of case reports[8-10], and the details of these characteristics are still unknown.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy

Horie¹,

Hosoe²,

Takabayashi³

et al. 2019

WJGE

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BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy (BAE) enable visualization of rare small bowel conditions such as small intestinal malignant tumors. However, details of the endoscopic characteristics of small intestinal malignant tumors are still unknown. AIM To elucidate the endoscopic characteristics of small intestinal malignant tumors. METHODS From March 2005 to February 2017, 1328 BAE procedures were performed at Keio University Hospital. Of these procedures, malignant tumors were classified into three groups, Group 1: epithelial tumors including primary small intestinal cancer, metastatic small intestinal cancer, and direct small intestinal invasion by an adjacent organ cancer; Group 2: small intestinal malignant lymphoma; and Group 3, small intestinal gastrointestinal stromal tumors. We systematically collected clinical and endoscopic data from patients’ medical records to determine the endoscopic characteristics for each group. RESULTS The number of patients in each group was 16 (Group 1), 22 (Group 2), and 6 (Group 3), and the percentage of solitary tumors was 100%, 45.5%, and 100%, respectively ( P < 0.001). Patients’ clinical background parameters including age, symptoms, and laboratory data were not significantly different between the groups. Seventy-five percent of epithelial tumors (Group 1) were located in the upper small intestine (duodenum and ileum), and approximately 70% of gastrointestinal stromal tumors (Group 3) were located in the jejunum. Solitary protruding or mass-type tumors were not seen in malignant lymphoma (Group 2) ( P < 0.001). Stenosis was seen more often in Group 1, (68.8%, 27.3%, and 0%; Group 1, 2, and 3, respectively; P = 0.004). Enlarged white villi inside and/or surrounding the tumor were seen in 12.5%, 54.5%, and 0% in Group 1, 2, and 3, respectively ( P = 0.001). CONCLUSION The differential diagnosis of small intestinal malignant tumors could be tentatively made based on BAE findings.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy

Horie¹,

Hosoe²,

Takabayashi³

et al. 2019

WJGE

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“…Pre-malignant lesions and polyposis syndromes are associated to increased risk of small bowel carcinoma warranting screening, surveillance and appropriate treatment ( 7 ). The knowledge of the epidemiology of SBTs helps to increase the awareness of this disease ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of enteroscopy on diagnosis and management of small bowel tumors

Safatle‐Ribeiro

Ribeiro

2020

Chinese Journal of Cancer Research

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Small bowel tumors (SBTs) have been increasingly diagnosed in recent decades. The pathogenesis of this increment is largely unknown, but advances in radiological and endoscopic methods facilitate the improvement of the diagnosis. Capsule endoscopy (CE) and device-assisted enteroscopy (DAE) allow the clinician to assess the entire small bowel in the search for suspicious lesions, or a cause of symptoms. In this review, we discuss the role of enteroscopy, techniques and strategies in the diagnosis and management of SBTs, and a brief description of the most common tumors.

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“…Nevertheless, many practitioners may feel compelled to proceed with small bowel investigations, particularly in elderly individuals, for fear of missing small bowel cancers, Crohn's disease or vascular ectasias that are at risk of re-bleeding. The reported prevalence of small bowel cancers in the general population, including adenocarcinoma, lymphoma, stromal tumours and others, is 1 to 1.5 per 100,000 persons [11,12].…”

Section: Introductionmentioning

confidence: 99%

Small Bowel Radiographic Imaging is Not Useful for Isolated Iron-Deficiency Anemia

Hae¹,

Murthy²

2019

Preprint

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Background Iron deficiency anemia in the absence of overt bleeding can result from chronic occult blood loss from the gastrointestinal tract. When esophagogastroduodenoscopy (EGD) and colonoscopy fail to demonstrate clinically significant lesions (CSLs), practitioners often consider small bowel investigations, such as CT enterography and video capsule endoscopy. Although most society guidelines recommend further investigations to evaluate the small bowel, few studies have evaluated the utility of small bowel radiographic imaging in this setting.Methods This is a retrospective cross-sectional study investigating the rates and types of CSLs identified during EGD, colonoscopy and small bowel imaging among individuals over age 50 who were referred for new-onset iron deficiency anemia without overt bleeding. Data was collected on 334 consecutive patients who underwent colonoscopy with or without EGD to evaluate new-onset iron deficiency anemia at The Ottawa Hospital from January 1, 2010 to March 30, 2012. We evaluated the frequency of CSLs among all patients and those who further underwent small bowel radiographic imaging.Results Of the 332 individuals who underwent colonoscopy, 42 (12.7%) were found to have a CSL, with 37 of these being malignancy or high-grade adenomas. Of the 258 individuals who also underwent EGD, 49 (19.0%) had CSLs, including 11 vascular ectasias, 15 peptic ulcer disease, 8 celiac disease, 8 severe erosive esophagitis, and 9 esophageal varices. Of 243 patients who did not have any CSLs identified on colonoscopy +/- EGD, 75 underwent subsequent small bowel imaging, and 9 patients underwent small bowel imaging despite having a CSL found on endoscopy. A total of 84 patients underwent subsequent small bowel imaging (68 CT enterography, 13 small bowel follow-through, one MR enterography, one CT enteroclysis, and one push enteroscopy). In these 84 patients, only one relevant CSL was found (inflammatory bowel disease).Conclusions Upper and lower endoscopy are valuable tools for diagnosing gastrointestinal tract lesions in individuals over the age of 50 with newly diagnosed iron deficiency anemia in the absence of overt bleeding. CT enterography and small bowel follow-through have limited utility in this setting.

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Small bowel tumors: A digestive endoscopy society of Taiwan (DEST) multicenter enteroscopy-based epidemiologic study

Cited by 22 publications

References 15 publications

Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy

Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy

Impact of enteroscopy on diagnosis and management of small bowel tumors

Small Bowel Radiographic Imaging is Not Useful for Isolated Iron-Deficiency Anemia

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