Estévez E, González-Conde B, Vázquez-Iglesias J L, Alonso P A, Vázquez-Millán M de los Angeles, Pardeiro R
Gastroenterology Department, Complexo Hospitalario Juan Canalejo, As Xubias de Arriba 84, 15006, A Coruña, Spain.
Surg Endosc. 2007 Oct;21(10):1776-80. doi: 10.1007/s00464-007-9242-8. Epub 2007 Mar 14.
Capsule endoscopy has involved a significant advance in techniques for imaging of the small bowel. Its most frequent indication is for studying patients with obscure gastrointestinal bleeding (OGIB). Small bowel tumors are infrequent, representing only 1% to 3% of all malignant gastrointestinal tumors. This study aimed to assess retrospectively the occurrence and characteristics of tumoral pathology diagnosed by means of capsule endoscopy in patients with OGIB.
A retrospective review analyzed the first 320 patients submitted to capsule endoscopy because of OGIB (166 with obscure overt bleeding and 154 with obscure occult bleeding) at a single center. The patients with a tumor diagnosis were analyzed in terms of incidence, characteristics, and treatment of OGIB pathology.
Tumor incidence was of 7.18% (23/320), with 65.2% of the cases supported with histologic confirmation (15/23). Obscure overt bleeding was the most frequent form of presentation, with the jejunum as the most frequent location (65.2%). For 16 patients, an intervention was conducted with a healing intent. Capsule endoscopy allowed the diagnosis of two cecal adenocarcinomas missed by colonoscopy.
Small bowel tumors are not an infrequent cause of OGIB. Capsule endoscopy, even if it does not allow determination of the benign or malignant nature or the histologic type of the tumor, is a useful tool for the diagnosis and early management of these tumors.
胶囊内镜检查在小肠成像技术方面取得了重大进展。其最常见的适应证是研究不明原因的胃肠道出血（OGIB）患者。小肠肿瘤并不常见，仅占所有胃肠道恶性肿瘤的1%至3%。本研究旨在回顾性评估通过胶囊内镜检查诊断的OGIB患者肿瘤病理学的发生率和特征。
一项回顾性研究分析了在单一中心因OGIB接受胶囊内镜检查的前320例患者（166例为不明原因显性出血，154例为不明原因隐性出血）。对诊断为肿瘤的患者的OGIB病理学的发生率、特征和治疗进行了分析。
肿瘤发生率为7.18%（23/320），其中65.2%的病例有组织学证实（15/23）。不明原因显性出血是最常见的表现形式，空肠是最常见的部位（65.2%）。16例患者进行了以治愈为目的的干预。胶囊内镜检查诊断出了结肠镜检查漏诊的2例盲肠腺癌。
小肠肿瘤是OGIB的常见原因。胶囊内镜检查即使不能确定肿瘤的良恶性性质或组织学类型，也是诊断和早期处理这些肿瘤的有用工具。
