Intestinal
tumors represent less than 6% of digestive
tumors, and, because of the limitations of intestinal investigations, these
tumors are difficult to diagnose. In this context,
capsule endoscopy has proven effective, especially in patients with obscure digestive
bleeding. In a large series of patients undergoing
capsule endoscopy, small bowel
tumors are found in 2.4-8.9% of cases. The aim of this retrospective, single-center study, based on prospective database, is to evaluate the frequency of small bowel
tumors detected by
capsule endoscopy in patients with occult gastrointestinal
bleeding. During 2004-2014, 849 consecutive patients underwent CE at our Department for occult gastrointestinal
bleeding. Following
capsule endoscopy, the medical records of the study population were reviewed. Results of double-balloon enteroscopy or surgery performed after
capsule endoscopy were retrieved.
Capsule endoscopy identified 55 small bowel
tumors (6.5%), of which 28
malignancies (51%) and 27
benign neoplasms (49%) underwent surgery or endoscopic treatment.
Malignancies included
adenocarcinoma (18.7%),
gastrointestinal stromal tumors (GIST) (12%) and
lymphoma (6.7%).
Benign neoplasms included dysplastic
adenomatous polyps (36%) and hyperplastic
polyps (25.3%). Non-neoplastic masses included one inflammatory
polyp.
Capsule retention occurred in four patients (5.3%) and the retained
capsule was retrieved during surgery. In our experience
neoplasms of small bowel are found in 6.5% of patients with occult gastrointestinal
bleeding. Of these
malignancies, small bowel
neoplasms are found in 3.3% of cases.
Capsule endoscopy is an effective and sensitive diagnostic tool, and plays an important role in the algorithm for the diagnostic workup of suspected small bowel
tumors.