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Small bowel tumors detected and missed during capsule endoscopy: Single center experience

World Journal of Gastroenterology 2013年第47期19卷 9043-9048页

作者： Edyta S Zagorowicz Anna M Pietrzak ewa Wronska Jacek Pachlewski Piotr Rutkowski ewa kraszewska Jaroslaw Regula Department of Gastroenterology The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology02-781 WarsawPoland Department of Gastroenterology and Hepatology Medical Center for Postgraduate Education01-813 WarsawPoland Department of Soft Tissue/Bone Sarcoma and Melanoma The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology02-781 WarsawPoland

AIM:To characterize small bowel(SB)tumors detected by capsule endoscopy(CE),and identify missed ***:The study included 145 consecutive patients in whom 150 CEs were *** CE,the medical records of the study population were *** of double-or single-balloon enteroscopy performed after CE and the results of surgery in all patients operated on were *** patients were contacted through telephone interviews or postal *** addition,the national cancer registry and the polish clinical gastrointestinal stromal tumor(GIST)Registry were searched to identify missed ***:Indications for CE included overt and occult obscure gastrointestinal bleeding(n=81,53.7%),anemia(n=19,12.7%),malabsorption(n=18,12%),abnormal CB follow through(n=9,6%),abdominal pain(n=7,5%),celiac disease(n=5,3%),neuroendocrine tumor(n=3,2%),Crohn’s disease(n=2,<2%),Peutz-Jeghers syndrome(n=2,<2%),other polyposes(n=2,<2%),and diarrhea(n=2,<2%).The capsule reached the colon in 115(76.6%)*** 150 investigations,CE identified 15SB tumors(10%),14 of which were operated on or treated *** included metastatic melanoma(n=1),adenocarcinoma(n=2),and GIST(n=3).Benign neoplasms included dysplastic Peutz-Jeghers polyps(n=4).Non-neoplastic masses included venous malformation(n=1),inflammatory tumors(n=2),and a mass of unknown histology(n=1).During the follow-up period,three additional SB tumors were found(2 GISTs and one mesenteric tumor of undefined nature).The National Cancer Registry and Polish Clinical GIST Registry revealed no additional SB neoplasms in the post-examination period(follow-up:range 4.2-102.5 mo,median 39 mo).The sensitivity of CE for tumor detection was 83.3%,and the negative predictive value was 97.6%.The specificity and positive predictive value were both 100%.CONCLUSION:Neoplasms may be missed by CE,especially in the proximal *** overt obscure gastrointestinal bleeding,complementary endoscopic and/or rad

关键词： Capsule endoscopy Small bowel tumor Tumor miss rate Gastrointestinal bleeding Gastrointestinal stromal tumor

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