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Capsule endoscopy enteroscopy

Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Stefania Chetcuti Zammit, Reena Sidhu
PURPOSE OF REVIEW: The objective is to provide an overview on the cause of small bowel bleeding. We discuss the role of small bowel endoscopy in the management of small bowel bleeding and provide an outline of pharmacotherapy that can be additionally beneficial. RECENT FINDINGS: Small bowel capsule endoscopy (SBCE) is the initial diagnostic investigation of choice in small bowel bleeding. Computed tomography (CT) can be helpful in the context of small bowel tumours...
March 7, 2018: Current Opinion in Gastroenterology
Cindy Ningfu Zhu, Joshua Friedland, Brian Yan, Aze Wilson, Jamie Gregor, Vipul Jairath, Michael Sey
BACKGROUND AND AIMS: Melena is a symptom of upper gastrointestinal bleeding and usually indicates bleeding proximal to the ligament of Treitz. However, whether melena predicts bleeding in the proximal small intestine in patients with obscure gastrointestinal bleeding (OGIB) is unknown and the objective of this study. METHODS: A retrospective cohort study of consecutive patients undergoing capsule endoscopy for OGIB between July 2009 and May 2016 was conducted. Subjects were categorized based on the presence of melena, and the primary outcome was identification of a bleeding source within the proximal 2/3 of the small intestine...
March 8, 2018: Digestive Diseases and Sciences
Cedric Van de Bruaene, Pieter Hindryckx, Laurens Van de Bruaene, Danny De Looze
PURPOSE OF REVIEW: Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special attention for vascular and ulcerative lesions, to provide the reader with a clinical guide and flow chart towards SB bleeding. RECENT FINDINGS: Absence of SB bleeding lesions on CE does not directly yield better prognosis; although having a lower rebleeding rate the first 2 years, rebleeding in the long term is high...
March 7, 2018: Current Gastroenterology Reports
L M Minordi, C Binda, F Scaldaferri, G Holleran, L Larosa, G Belmonte, A Gasbarrini, C Colosimo, R Manfredi
OBJECTIVE: Primary small intestinal neoplasms are uncommon tumors that are often small and difficult to identify. The aim of this paper is to describe CT technique and features in detecting and characterizing the tumors of the small bowel. MATERIALS AND METHODS: This paper focuses on radiological characteristics of benign and malignant primary neoplasms of the small bowel at CT, with special reference to multidetector-CT techniques, type and modality of administration of contrast agents (by oral route or CT-enterography and by nasojejunal tube or CT-enteroclysis)...
February 2018: European Review for Medical and Pharmacological Sciences
Yuxin Wang, Huan Han, Yiqi Du
A 27-year-old man referred to our department with a 1-month history of intermittent melena and dizziness. Gastroscopy and colonoscopy did not identify the site of bleeding. Laboratory data showed hemoglobin 6.6g/dL. Video capsule endoscopy (CE, Anhon,China) and antegrade double-ballon enteroscopy (DBE, EN450P5, Fujinon, Japan) were carried out and a space occupying lesion in the proximal jejunum was identified (Fig.1). Ink tattooing via DBE was performed to mark the site of the tumor.Then the patient underwent jejunectomy...
February 17, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Rondonotti Emanuele, Anastasios Koulaouzidis, Julius Georgiou, Marco Pennazio
PURPOSE OF REVIEW: The aim of this study was to summarize the role of recently developed diagnostic techniques in the diagnosis and management of patients with small bowel tumours (SBTs). RECENT FINDINGS: Recent studies show that the overall SBT incidence is increasing. The introduction of small bowel dedicated diagnostic tools [i.e. capsule endoscopy, device-assisted enteroscopy (DAE), computed tomography (CT) and MRI-enterography] might partially explain this trend...
February 12, 2018: Current Opinion in Gastroenterology
Shogo Miura, Hiroyuki Kuroda, Ken Sato, Michiko Yamada, Ryo Itou, Michihiro Ono, Tomoyuki Abe, Shigeyuki Fujii, Masahiro Maeda, Masahiro Yoshida, Wataru Jomen, Masayoshi Kobune, Junji Kato, Miri Fujita
The gastrointestinal tract is a common site for the occurrence of non-Hodgkin's lymphoma (NHL). NHL with gastrointestinal lesions may lead to clinically relevant intestinal complications such as obstruction, perforation, and exsanguination during the course of the disease. Consequently, patients with NHL are often examined by means of upper and lower gastrointestinal endoscopy at the initial visit. There are no clear guidelines regarding which patients should undergo capsule endoscopy (CE) and balloon enteroscopy for detecting small intestinal lesions...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Koji Otani, Toshio Watanabe, Sunao Shimada, Shuhei Hosomi, Yasuaki Nagami, Fumio Tanaka, Noriko Kamata, Koichi Taira, Hirokazu Yamagami, Tetsuya Tanigawa, Masatsugu Shiba, Yasuhiro Fujiwara
BACKGROUND: Obscure gastrointestinal bleeding (OGIB) is a common but embarrassing problem for gastroenterologists. Most bleeding lesions associated with OGIB are present in the small intestine and sometimes cannot be identified due to the difficulty associated with physical accessibility. Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have enabled in the process of diagnosing and have evolved to become approaches to treating OGIB. SUMMARY: CE is a minimally invasive procedure and has a high diagnostic yield in patients with OGIB...
February 1, 2018: Digestion
Eelco de Bree, Koen P Rovers, Dimitris Stamatiou, John Souglakos, Dimosthenis Michelakis, Ignace H de Hingh
BACKGROUND: Small bowel adenocarcinoma (SBA) is rare despite the fact that the small bowel represents the longest part and has the largest surface of all alimentary tract sections. Its incidence is 50-fold lower than that of colorectal carcinoma. It is often diagnosed at an advanced stage due to atypical and late symptoms, its low index of suspicion, difficult endoscopic access and poor detection by radiological imaging, resulting in impaired outcome. Due to its rarity and being molecularly a unique intestinal cancer, data regarding its optimal management are relatively sparse...
January 30, 2018: Acta Oncologica
J Castela, S Mão de Ferro, S Ferreira, R Cabrera, A Dias Pereira
Pyogenic granuloma is a benign vascular lesion, uncommon in the gastrointestinal tract, and extremely rare in the small bowel. The diagnosis can be challenging prior to surgery, because of its unusual endoscopic appearance.We present a case of pyogenic granuloma of the jejunum diagnosed by capsule endoscopy and double-balloon enteroscopy and successfully managed by surgical resection.
January 26, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jonathan Green, Christopher R Schlieve, Ann K Friedrich, Kevin Baratta, David H Ma, May Min, Krunal Patel, David Stein, David R Cave, Demetrius E Litwin, Mitchell A Cahan
BACKGROUND: Small bowel lesions (SBL) are rare, representing diagnostic and management challenges. The purpose of this cross-sectional study was to evaluate diagnostic modalities used and management practices of patients with SBL at an advanced endoscopic referral center. METHODS: We analyzed patients undergoing surgical management for SBL from 2005 to 2015 at a single tertiary care center. Patients were stratified into gastrointestinal bleed/anemia (GIBA) or obstruction/pain (OP)...
January 25, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Emmanuel Ofori, Daryl Ramai, Charilaos Papafragkakis, Kinesh Changela, Mahesh Krishnaiah
Small intestinal tumors are rare with adenocarcinoma of the small intestine accounting for less than 2% of all gastrointestinal cancers. Primary jejunal adenocarcinoma constitutes a minute portion of small intestine adenocarcinomas. Clinically, this cancer presents at latter stages of its progression, mainly due to vague and non-specific symptoms, and the difficulty encountered in accessing the jejunum on upper endoscopy. Diagnosis of jejunal adenocarcinoma is usually inconclusive with the use of computed tomography (CT) scan, small bowel series, or upper endoscopy...
December 2017: Gastroenterology Research
Michael G Noujaim, Jonathan Green, May Min, Christopher R Schlieve, Krunal Patel, Mitchell Cahan, David Cave
Background: Neuroendocine tumors (NETs) or carcinoids arise at many different sites of the gastrointestinal tract. The small intestine is the most common site for NETs. Diagnosing small bowel carcinoids remains challenging given their non-specific presentations and the overall low incidence of small bowel tumors. Video capsule endoscopy (VCE) has significanly improved our ability to detect small bowel malignancies. We explore the value of VCE in the initial workup and management of a series of small bowel carcinoid patients...
December 2017: Gastroenterology Research
C Römmele, A Ebigbo, M Schrempf, H Messmann, S K Gölder
Background and Aims: Balloon-assisted enteroscopy (BAE) is a well-established tool in the diagnosis and therapy of small bowel diseases. Ink tattooing of the small bowel is used to mark pathologic lesions or the depth of small bowel insertion. The purpose of this study was to determine the safety, the detection rate, and the clinical relevance of ink tattooing during BAE. Methods: We performed a retrospective analysis of all 81 patients who received an ink tattooing during BAE between 2010 and 2015...
2017: Gastroenterology Research and Practice
Bing Yan Xue, Qi Yun Tang
We present one case of a 17-year-old male with ten-year history of anemia complaining of recurrent bloody stools, abdominal pain and fatigue for 3 months.The gastroscopy, colonoscopy, the-first-time double-balloon enteroscopy (DBE) through the anus and capsule endoscopy were performed with negative results. 99mTc-pertechnetate scan showed a round-like high radioactive concentration at the ileocecum. Double-balloon enteroscopy through the anus was performed again by a more-experienced endoscopic physician, the diverticulum was found at a distance of 50 cm to the ileocecal valve...
January 2018: Revista Española de Enfermedades Digestivas
Shinji Okabayashi, Taku Kobayashi, Tomohisa Sujino, Ryo Ozaki, Satoko Umeda, Takahiko Toyonaga, Eiko Saito, Masaru Nakano, Maria Carla Tablante, Shojiroh Morinaga, Toshifumi Hibi
Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down...
October 2017: Intestinal Research
Anjan K Banerjee, Valerio Celentano, Jim Khan, Gaius Longcroft-Wheaton, Amanda Quine, Pradeep Bhandari
About 10% of oesophagogastroduodenoscopies (OGDs) and colonoscopies are done for investigation of iron deficiency anemia (IDA) . Much of the existing guidance on investigation of IDA predates CRC screening, which has driven significant improvements in colonoscopy quality and completion rates, as well as a reduction in Helicobacter pylori prevalence and increase in PPI usage, and therefore probably needs re-consideration. New investigations, e.g. CT colonography, enteroscopy and capsule endoscopy have also been introduced...
March 2018: Expert Review of Gastroenterology & Hepatology
Alexandra Gangi, Emily Siegel, Galinos Barmparas, Simon Lo, Laith H Jamil, Andrew Hendifar, Nicholas N Nissen, Edward M Wolin, Farin Amersi
BACKGROUND: Neuroendocrine tumors (NETs) account for 30% of small bowel (SB) neoplasms. The objectives of this study were to evaluate the incidence of multifocality in primary small bowel neuroendocrine tumors (SBNETs) and to examine the associated outcomes. METHODS: Patients with multifocal SBNET were compared to those with a solitary lesion. Only patients who underwent diagnostic workup and surgical intervention at our institution were included in this study. The primary aim of our study was surgical outcomes and mortality and recurrence...
November 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Thomas A Zikos, Jennifer Pan, Berkeley Limketkai, Dipanjan Banerjee, Nielsen Fernandez-Becker
Background: Continuous flow left ventricular assist device (CF-LVAD) patients have a high prevalence of gastrointestinal bleeding from the small bowel. Video capsule endoscopy (VCE) is often used for diagnosis in these patients, but efficacy has yet to be determined. In this study, we evaluated the efficacy of VCE in the management of CF-LVAD patients with suspected small bowel bleeding by comparing to a non-VCE CF-LVAD control group. Methods: We retrospectively reviewed the charts of all patients with CF-LVADs implanted at Stanford Hospital from January 2010 to October 2015...
October 2017: Gastroenterology Research
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