학술논문
Characteristics of Small Bowel Tumors Detected by Double Balloon Endoscopy
Document Type
Academic Journal
Author
Imaoka, Hiroya; Higaki, Naoyuki; Kumagi, Teru; Miyaike, Jirou; Ohmoto, Masaki; Yamauchi, Kazuhiko; Murakami, Takatoshi; Murakami, Hidehiro; Ikeda, Yoshiou; Yokota, Tomoyuki; Shibata, Naozumi; Ninomiya, Tomoyuki; Abe, Masanori; Hiasa, Yoichi; Matsuura, Bunzo; Onji, Morikazu; Umeda, Masakichi; Horiike, Norio
Source
Digestive Diseases and Sciences. Aug 01, 2011 56(8):2366-2371
Subject
Language
English
ISSN
0163-2116
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 orulceration were the most frequently observed endoscopic findings (n — = 13, 65%). All primary adenocarcinomas and three of four (75%) metastatic cancers showed stenosis orulceration. 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.