Han Jung Wan, Hong Sung Noh, Jang Hyun Joo, Jeon Seong Ran, Cha Jae Myung, Park Soo Jung, Byeon Jung Sik, Ko Bong Min, Kim Eun Ran, Choi Hwang, Chang Dong Kyung
Division of Gastroenterology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 40 Sukwoo-dong, Hwaseong-si, Gyeonggi-do 445-170, Republic of Korea.
Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Gastroenterol Res Pract. 2015;2015:623208. doi: 10.1155/2015/623208. Epub 2015 Jul 2.
Background. We aimed to evaluate the efficacy of various diagnostic tools such as computerized tomography (CT), small bowel follow-through (SBFT), and capsule endoscopy (CE) in diagnosing small bowel tumors (SBTs). Additionally, we aimed to evaluate the clinical features of SBTs missed by CE. Methods. We retrospectively studied 79 patients with histologically proven SBT. Clinical data were analyzed with particular attention to the efficacy of CT, SBFT, and CE in detecting SBT preoperatively. We also analyzed the clinical features of SBTs missed by CE. Results. The most common symptoms of SBT were bleeding (43%) and abdominal pain (13.9%). Diagnostic yields were as follows: CT detected 55.8% of proven SBTs; SBFT, 46.1%; and CE, 83.3%. The sensitivity for detecting SBTs was 40.4% for CT, 43.9% for SBFT, and 79.6% for CE. Two patients with nondiagnostic but suspicious findings on CE and seven patients with negative findings on CE were eventually found to have SBT. These nine patients were eventually diagnosed with gastrointestinal stromal tumor (4), small polyps (3), inflammatory fibroid polyp (1), and adenocarcinoma (1). These tumors were located in the proximal jejunum (5), middle jejunum (1), distal jejunum (1), and proximal ileum (1). Conclusion. CE is more efficacious than CT or SBFT for detecting SBTs. However, significant tumors may go undetected with CE, particularly when located in the proximal jejunum.
背景。我们旨在评估各种诊断工具，如计算机断层扫描（CT）、小肠钡剂造影（SBFT）和胶囊内镜（CE）在诊断小肠肿瘤（SBT）方面的疗效。此外，我们旨在评估CE漏诊的SBT的临床特征。方法。我们回顾性研究了79例经组织学证实的SBT患者。分析临床数据，特别关注CT、SBFT和CE术前检测SBT的疗效。我们还分析了CE漏诊的SBT的临床特征。结果。SBT最常见的症状是出血（43%）和腹痛（13.9%）。诊断率如下：CT检测出55.8%的经证实的SBT；SBFT为46.1%；CE为83.3%。CT检测SBT的敏感性为40.4%，SBFT为43.9%，CE为79.6%。最终发现2例CE检查结果未明确但可疑的患者和7例CE检查结果为阴性的患者患有SBT。这9例患者最终被诊断为胃肠道间质瘤（4例）、小息肉（3例）、炎性纤维瘤息肉（1例）和腺癌（1例）。这些肿瘤位于空肠近端（5例）、空肠中段（1例）、空肠远端（1例）和回肠近端（1例）。结论。CE在检测SBT方面比CT或SBFT更有效。然而，CE可能会漏诊一些较大的肿瘤，特别是当它们位于空肠近端时。
