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Characteristics of Small Bowel Tumors Detected by Double Balloon Endoscopy

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Abstract

Background

A few reports suggest that the emergence of double balloon endoscopy (DBE) has likely changed the clinical picture of small bowel tumors (SBTs).

Aim

To further clarify the characteristics of SBTs detected by DBE.

Methods

A retrospective chart review was conducted in 227 patients who had undergone DBE.

Results

The SBT group contained more symptomatic patients than the non-SBT group (90% vs. 49%, P < 0.0005) with a significantly higher rate of gastrointestinal symptoms at presentation (72% vs. 33%, P < 0.005). Twenty patients (8.8%) were eventually diagnosed with SBT, and their indications for DBE were obscure gastrointestinal bleeding (n = 5), abdominal pain (n = 5), abdominal fullness (n = 5), vomiting (n = 2), and diarrhea (n = 1). Tumors were located in the jejunum in 14 patients (70%) and in the ileum in 6 (30%). A final histological diagnosis was assigned to all 20 patients: primary adenocarcinoma (n = 8, 40%), malignant lymphoma (n = 5, 25%), metastatic cancer (n = 4, 20%), gastrointestinal stromal tumor (n = 1, 5%), carcinoid tumor (n = 1, 5%) and inflammatory fibroid polyp (n = 1, 5%). Stenosis or ulceration were the most frequently observed endoscopic findings (n = 13, 65%). All primary adenocarcinomas and three of four (75%) metastatic cancers showed stenosis or ulceration. Three of five (60%) malignant lymphomas showed multiple lymphomatous polyps. All patients but one underwent surgical resection or chemotherapy or both.

Conclusion

DBE is a safe and useful procedure that enables a precise diagnosis of SBTs.

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Fig. 1

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Abbreviations

CE:

Capsule endoscopy

DBE:

Double balloon endoscopy

GISTs:

Gastrointestinal stromal tumors

MLP:

Multiple lymphomatous polyposis

OGIB:

Obscure gastrointestinal bleeding

SBT:

Small bowel tumor

SMT:

Submucosal tumor

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Conflict of interest

All authors have nothing to disclose.

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Correspondence to Teru Kumagi.

Additional information

The authors Hiroya Imaoka and Naoyuki Higaki contributed equally to this work.

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Imaoka, H., Higaki, N., Kumagi, T. et al. Characteristics of Small Bowel Tumors Detected by Double Balloon Endoscopy. Dig Dis Sci 56, 2366–2371 (2011). https://doi.org/10.1007/s10620-011-1741-8

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  • DOI: https://doi.org/10.1007/s10620-011-1741-8

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