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CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(06): E463-E470
DOI: 10.1055/s-0043-106186
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Small bowel malignancy in patients undergoing capsule endoscopy at a tertiary care academic center: Case series and review of the literature

Connor A Johnston
1   College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
,
Diana E Yung
2   Centre for Liver and Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, UK
,
Alka Joshi
3   Ninewells Hospital and Medical School, Dundee, UK
,
John N Plevris
1   College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
2   Centre for Liver and Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, UK
,
Anastasios Koulaouzidis
2   Centre for Liver and Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, UK
› Author Affiliations
Further Information

Publication History

submitted 09 September 2016

accepted after revision 02 March 2017

Publication Date:
31 May 2017 (online)

Also available at
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Abstract

Background and study aims Small bowel cancer is rare, accounting for < 5 % of all gastrointestinal neoplasms. Capsule endoscopy has become the procedure of choice for non-invasive diagnosis of small bowel diseases. Data on capsule endoscopy diagnosis of small bowel cancer are limited. The objective of the study was to determine the frequency, indications and diagnostic work-up of patients with small bowel malignancy found by capsule endoscopy at a Scottish tertiary center.

Patients and methods In this retrospective study, records all patients who underwent small bowel capsule endoscopy at our center over a 10-year period were reviewed for possible malignancy. Further data were gathered on preceding and subsequent investigations, management and outcome of these patients. 

Results From 1949 studies, small bowel malignancies were diagnosed in only 7 patients (0.36 %; 2F/5M; median age 50, range 34 – 67). The main indication was iron-deficiency anemia (n = 5). Prior to capsule endoscopy, 6 of 7 patients had bidirectional endoscopies and one had gastroscopy. All prior investigations were normal or nondiagnostic. Two of 7 experienced capsule retention. Five of 7 underwent surgery. Four patients died, giving a 5-year survival rate of 42.9 %.

Conclusion Small bowel malignancies diagnosed by capsule endoscopy are rare, and the median age of 50 indicates they are more common in relatively younger patients. Capsule endoscopy is effective at diagnosing a rare malignancy when other imaging modalities have failed.

 

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