Significant small-bowel lesions detected by alternative diagnostic modalities after negative capsule endoscopy

Postgate, Aymer; Despott, Edward J.; Burling, David; Gupta, Arun; Phillips, R. K. S.; O’Beirne, James; Patch, David; Fraser, Chris

doi:10.1016/j.gie.2008.06.035

Cited by 141 publications

(95 citation statements)

References 25 publications

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“…Although it is a minimally invasive test, capsule endoscopy enables the diagnosis of various disorders of the small intestine, such as vascular abnormalities, ulcerative lesions, and tumors [4][5][6][7][8][9][10]. However, false positive or false negative results for small bowel tumors are limitations of capsule endoscopy [11][12][13], and capsule retention occasionally occurs. Moreover, histologic confirmation is not available for capsule endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Small Bowel Tumors Diagnosed by Double-Balloon Endoscopy: KASID Multi-Center Study

Lee

Choi

et al. 2011

Dig Dis Sci

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Background Small bowel tumors are relatively rare, and their confirmative diagnosis before surgery is not easy. Aims This study was performed to investigate the clinical characteristics of patients with small bowel tumors who received double-balloon enteroscopy (DBE). Secondary end points were to evaluate the usefulness and safety of DBE for the diagnosis of patients with suspected SB tumors derived from other previous procedures. Methods We retrospectively analyzed consecutive DBE examinations to explore the small intestine in eight university hospitals over a 5-year period. Results A total of 877 DBE examinations (per oral 487, per anal 390) were performed in 645 patients (405 males, mean age 48.2 years). Small bowel tumors were diagnosed in 112 patients (17.4%), of which 38 patients had benign polyps, 29 had gastrointestinal stromal tumors/leiomyomata, 18 had lymphomas, 14 had adenocarcinomas, five had metastatic or invasive cancers, five had lipomas, and three patients had cystic tumors. The main reasons for DBE among patients with small bowel tumors were obscure gastrointestinal bleeding (OGIB, 40.2%) followed by abnormal imaging study (25.2%). The concordance rate of diagnoses based on DBE with diagnoses based on small bowel follow-through, CT, and capsule endoscopy among patients with small bowel tumors was 68.9% (42/61), 75.3% (70/93), and 78.3% (18/23), respectively. Therapeutic plans were changed due to the DBE results in 64.2% of patients with small bowel tumors. Conclusions Approximately one-sixth of patients who received DBE had small bowel tumors, and the most common reason for DBE among patients with small bowel tumors was OGIB. DBE is a useful method for the 123Dig Dis Sci (2011) 56:2920-2927 DOI 10.1007/s10620-011-1839 confirmative diagnosis of small bowel tumors and has a good clinical impact on therapeutic plans and short-term clinical results.

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Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Small Bowel Tumors Diagnosed by Double-Balloon Endoscopy: KASID Multi-Center Study

Lee

Choi

et al. 2011

Dig Dis Sci

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“…The risk with the very high sensitivity for mucosal changes is that unspecific, not clinically relevant changes could be found. 3 At the same time, there is increasing evidence that significant tumor lesions may be missed, even under optimal conditions, especially within the proximal small intestine 4 and when there are solitary lesions or masses within an otherwise normal small intestine. 5 The VCE only shows the mucosa, not an obstruction, dilation, or the thickness of the intestinal wall.…”

Section: Discussionmentioning

confidence: 99%

“…Balloon enteroscopy, MRE, and CTE have the potential to avoid some of these disadvantages of VCE. 4,6 Comparisons between VCE and DBE emphasize the advantages of DBE. 4,7 However, SBE and DBE require considerable expertise and are significantly more invasive than VCE.…”

Section: Discussionmentioning

confidence: 99%

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A case report concerning the importance of the patients’ symptoms and clinical findings in the management of patients

Ohlsson¹

2010

Gastroenterol Insights

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The gastrointestinal tract has always been difficult to visualize in its entire length. New technology such as magnetic resonance imaging enterography, computed tomography entero graphy, single-and double-balloon enteroscopy, and video capsule enteroscopy have improved the possibilities for visualizing mucosal changes and pathology in the small intestine. We describe here a case of a patient with gastrointestinal signs and symptoms suggesting recurrent intestinal obstruction over a period of several years, who had mostly normal morphology on endoscopic examination.Nonetheless, after some delay, the patient underwent explorative surgery because of his accelerating symptoms. Abdominal exploration revealed a Meckel's diverticulum, which had led to inflammatory adhesions of the small intestine with a sharp bend and proximal intestinal dilation. After the operation the patient's health was restored. We concluded that in certain situations the clinician should rely on the patients' symptoms and clinical findings more than on technological examinations and the clinical picture should guide clinicians' interventions, even though we live in a high-technique era.

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“…Nevertheless, it does enable us to provide a diagnosis in a large number of patients with undi- agnosed gastrointestinal bleeding, and it gives us the opportunity to treat bleeding, especially in vascular lesions. An alternative approach involves single-balloon enteroscopy (16,17), which enables us to explore a greater length of the small intestine, albeit with less efficacy than with the double-balloon technique.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of pediatric colonoscopy used as push enteroscopy in the management of capsule endoscopy findings

Roldán

Carro

Huidobro

et al. 2009

Rev. esp. enferm. dig.

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Significant small-bowel lesions detected by alternative diagnostic modalities after negative capsule endoscopy

Cited by 141 publications

References 25 publications

Clinical Characteristics of Small Bowel Tumors Diagnosed by Double-Balloon Endoscopy: KASID Multi-Center Study

Clinical Characteristics of Small Bowel Tumors Diagnosed by Double-Balloon Endoscopy: KASID Multi-Center Study

A case report concerning the importance of the patients’ symptoms and clinical findings in the management of patients

Efficacy of pediatric colonoscopy used as push enteroscopy in the management of capsule endoscopy findings

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