Small Intestinal Angioectasias Are Not Randomly Distributed in the Small Bowel and Most May Be Reached by Push Enteroscopy

Plotkin, Eileen; Imaeda, Avlin B.

doi:10.1097/mcg.0000000000000425

Cited by 19 publications

(12 citation statements)

References 15 publications

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“…To the best of our knowledge, this is the first study presenting a large consecutive patient-series, in a clinical practice setting, undergoing VCE with CapsoCam SV. It should be noted however that in patients with positive VCE, 25% of P2 lesions were located in the upper GI tract, whereas the distribution of P2 lesions along the small bowel was similar to that described in previous studies [25,26]. Although it is well known that upper GI lesions may be missed by conventional gastroscopy and identified at the time of VCE, the frequency reported in studies using forward-viewing cameras is lower than that observed in our study (range 4-…”

Section: Discussioncontrasting

confidence: 55%

Small-bowel capsule endoscopy with panoramic view: results of the first multicenter, observational study (with videos)

Tontini

Wiedbrauck

Cavallaro

et al. 2017

Gastrointestinal Endoscopy

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Section: Discussioncontrasting

confidence: 55%

Small-bowel capsule endoscopy with panoramic view: results of the first multicenter, observational study (with videos)

Tontini

Wiedbrauck

Cavallaro

et al. 2017

Gastrointestinal Endoscopy

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“…Moreover, in this study, vascular lesions were frequently observed in the proximal small bowel even though the retrospective type of study did not allow a comparison of VCE with enteroscopy. However, despite the fact that the reason for this location is unclear, this finding could explain what is reported in the literature, i.e., the good performance of enteroscopy in identifying and, mostly, in treating this type of injury [22,23]. Finally, a recent European study showed that the diagnostic yield of VCE was not adequately effective in the case of small bowel masses when they did not protrude into the lumen [24].…”

Section: Discussionmentioning

confidence: 99%

The Spectrum of Small Intestinal Lesions in Patients with Unexplained Iron Deficiency Anemia Detected by Video Capsule Endoscopy

et al. 2019

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Background and objectives: Video-capsule endoscopy (VCE) has shown a large range (38–83%) of diagnostic yield in unexplained iron deficiency anemia (IDA) and obscure-occult bleeding. Therefore, we retrospectively investigated the VCE-detected spectrum and the prevalence of small bowel injuries and associated risk factors in inpatients with both of the above reported conditions. Methods: We selected inpatients with IDA (hemoglobin <12 g/dL in women, <13 g/dL in men) and obscure-occult bleeding. We excluded VCE indications other than IDA. Complete medical histories and laboratory tests were collected. All subjects underwent PillCam SB2/SB3. The VCE feature Lewis score was calculated when appropriate. We used the t-test and Fisher’s exact test for continuous and categorical variables, respectively, in univariate analysis. For multivariate analysis, we used binomial logistic regression. Results: We retrieved 109 patients (female:male ratio of 53:56; age 63.4 ± 18.9 years). Eighty patients (73.4%) showed ≥1 small bowel lesions. The Lewis score was calculated in 41 patients: 13 (31.7%) showed a mild (<135) and 28 (68.3%) a moderate-severe (135–790 and >790, respectively) score. In univariate analysis, the small bowel transit time (6.2 ± 2.9 versus 5.2 ± 2.1 h; p = 0.049) and non-steroidal anti-inflammatory drug use for at least two weeks (17.5% versus 0%; p = 0.01) were significantly higher in subjects with injuries. These associations were not confirmed at multivariate analysis. The severity of a lesion directly correlated with proton pump inhibitor (PPI) use and duration (not confirmed in multivariate analysis). VCE can reveal the source of obscure-occult bleeding in a high percentage of unexplained IDAs. A wide spectrum of endoscopic pictures may be found. Known as well as supposed risk factors for small bowel lesions may be detected.

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“…Of these lesions, 67% were in the duodenum and 78% were within the first 25% of small bowel transit, suggesting that the majority of these lesions are within the reach of PE. 18 Thus, PE may be useful when VCE localizes lesions to the proximal small bowel.…”

Section: Push Enteroscopymentioning

confidence: 99%

Bleeding from Small Intestine: No Man's Land

Sahakian

Lee

Shin

2020

Clinics in Colon and Rectal Surgery

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Bleedings from small intestine account for 5% of all gastrointestinal bleeding. With advanced endoscopic tools, such as video capsule endoscopy and deep enteroscopy, accurate diagnosis and treatment is possible in majority of cases with low mortality and morbidity. Nonoperative management includes endoscopic hemostasis and angiographic embolization. Recurrence after initial treatment is relatively common. Surgery is reserved for the cases that are refractory to endoscopic or angiographic treatment, bleeding from tumor or mass lesions, or hemodynamic instability. At the time of surgical exploration, unless the lesion has been marked by endoscopic tattoo or clip, intraoperative enteroscopy is often necessary to localize the lesion.

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Small Intestinal Angioectasias Are Not Randomly Distributed in the Small Bowel and Most May Be Reached by Push Enteroscopy

Abstract: Push enteroscopy for bleeding angioectasias is effective in many patients. Deep enteroscopy may not benefit most patients as most angioectasias are proximal. Patients with deeper lesions tended to have multiple lesions and rebleeding despite deep enteroscopy.

Cited by 19 publications

References 15 publications

Small-bowel capsule endoscopy with panoramic view: results of the first multicenter, observational study (with videos)

Small-bowel capsule endoscopy with panoramic view: results of the first multicenter, observational study (with videos)

The Spectrum of Small Intestinal Lesions in Patients with Unexplained Iron Deficiency Anemia Detected by Video Capsule Endoscopy

Bleeding from Small Intestine: No Man's Land

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