Roles of Capsule Endoscopy and Device-Assisted Enteroscopy in the Diagnosis and Treatment of Small-Bowel Tumors

Abstract

With the development of capsule endoscopy (CE) and device-assisted enteroscopy (DAE), the incidence of small-bowel tumors has increased and the characteristics of these tumors have changed. In addition, the diagnostic and therapeutic approaches for small-bowel tumors have diversified. CE is a simple, noninvasive method that aid in the visualization the entire small bowel. CE is considered the initial approach for small-bowel tumors. DAE can be used to perform endoscopic procedures such as bleeding control, polypectomy, stent insertion, and tattooing, as well as for diagnosis through visualization or tissue sampling. Therapeutic intervention with DAE is particularly useful in polyposis syndromes such as familial adenomatous polyposis and Peutz-Jeghers syndrome. This review will discuss the roles of CE and DAE in the diagnosis and treatment of small-bowel tumors. Clin Endosc 2020;53:410-416

Ileal neuroendocrine tumor: diagnosis by endoscopic capsule

“…The authors highlighted the role of preoperative diagnosis and elective surgery on better outcomes (Folkestad et al, 2020). An initial concern was about GI adenocarcinoma or GIST (Kim et al, 2020;Yoo et al, 2020).…”

“…Besides, metastases from melanoma, lung cancer, breast cancer, cervical cancer, sarcoma, and colon cancer are more common than primary tumors (Kim et al, 2020). Because the upper digestive endoscopy, angiotomography, abdominal tomography, and colonoscopy of control did not show any change, we performed the CE, utilized since 2001 to visualize the small bowel and its mucosa by high-quality images.…”

“…Besides, CE can have a better diagnostic yield than other routine imaging modalities to detect of smaller jejunoileal polyps (Kim et al, 2020). The concern about CE was related to eventual difficulty of distinguishing submucosal lesions from innocent bulges.…”

“…Promisors in monitoring the disease are circulating tumor cells or tumor transcripts (Kim et al, 2020). The estimated detection rate of small-bowel tumors by capsule is from 2% to 9%, and capsule retention is rare (up to 2.6% of cases), more often in intestinal obstruction (Levy et al, 2020).…”

“…We report the case of a patient with episodes of obscure intestinal hemorrhage. Being uncommon, with nonspecific symptoms, SINETs cause diagnostic pitfalls, but images by capsule endoscopy (CE) and enteroscopy allow early diagnosis (Kim et al, 2020;Perez-Cuadrado-Robles et al, 2020;Rondonotti et al, 2020;Vasilakakis et al, 2020;Yoo et al, 2020). Intestinal bleeding of unknown origin is a common symptom of adenocarcinoma and gastrointestinal stromal tumors (GISTs), which may propitiate diagnostic challenges or misdiagnosis with NETs (Yoo et al, 2020).…”