Elsevier

Gastrointestinal Endoscopy

Volume 62, Issue 3, September 2005, Pages 448-452
Gastrointestinal Endoscopy

Case Study
Initial experience of videocapsule endoscopy for diagnosing small-bowel tumors in patients with GI polyposis syndromes

https://doi.org/10.1016/S0016-5107(05)01582-8Get rights and content

Background

Small-bowel tumors frequently occur in familial adenomatous polyposis and other GI polyposis syndromes. These tumors are difficult to detect with conventional techniques. Our aim was to assess the utility of videocapsule endoscopy in the detection of small-bowel tumors in this setting.

Methods

We examined 19 familial adenomatous polyposis patients and 3 patients with either Peutz-Jeghers syndrome, hyperplastic polyposis, or Cowden disease.

Observations

Prevalence of small-bowel polyps on videocapsule endoscopy was 59% in all patients, 52.6% in familial adenomatous polyposis patients, and 75% in a subgroup of familial adenomatous polyposis patients with exon 15 mutations. Videocapsule endoscopy was safe and well tolerated in all patients.

Conclusions

Videocapsule endoscopy has a high yield in detecting small-bowel tumors in patients with GI polyposis syndromes. It may be especially indicated in familial adenomatous polyposis patients with the aggressive phenotype of the disease, e.g., mutations in exon 15.

Section snippets

Patients and methods

The present study was an open, prospective, nonrandomized clinical trial, which evaluated the use of videocapsule endoscopy in patients with GI polyposis syndromes.

Included in the study were men and women patients, 18 to 70 years of age, with a GI polyposis syndrome, who have been followed in our clinic. Excluded from the study were patients with severe swallowing disorders, implanted cardiac pacemaker or other electronic devices, pregnant women, and patients with a clinical suspicion of

Demographics, indications, and SBFT findings

Twenty-two patients (13 men and 9 women, age range 19-55 years, mean age 41 years), including 19 patients with FAP, one patient with PJS, one patient with hyperplastic polyposis, and one patient with Cowden disease were enrolled from September 2003 to September 2004. All the FAP patients had undergone colectomy (9 had total proctocolectomy with ileoanal pouch, 4 had colectomy with ileorectal anastomosis, two had total proctocolectomy with continent ileostomy (Kock pouch), and 4 had total

Discussion

Patients with GI polyposis syndromes have a high prevalence of small-bowel polyps as detected by VCE (59%). In FAP patients, the prevalence of small-bowel polyps was 52.6%.

Before the VCE era, duodenoscopy, push enteroscopy, and small-bowel barium studies were used to detect small-bowel polyps. The sensitivity of small-bowel barium studies for the detection of small-bowel polyps has been thought to be low, though this has never formally investigated. Indeed, in our study, SBFT identified only 3

References (20)

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