Cheung Dae Young, Kim Jin Su, Shim Ki-Nam, Choi Myung-Gyu
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Clin Endosc. 2016 Jan;49(1):21-5. doi: 10.5946/ce.2016.49.1.21. Epub 2016 Jan 28.
Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. The clinical application of VCE is mainly for obscure gastrointestinal bleeding (OGIB) and small bowel tumor is one of the clinically significant diagnoses of VCE, often requiring subsequent invasive interventions. Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. Protruding mass with bleeding, mucosal disruption, irregular surface, discolored area, and white villi are suggested as the VCE findings of small bowel tumor. Device assisted enteroscopy (DAE), computed tomography enteroclysis/enterography and magnetic resonance enteroclysis/enterography also have clinical value in small bowel examination and tumor detection, and they can be used with VCE, sequentially or complementarily. Familial adenomatous polyposis, Peutz-Jeghers syndrome, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are the high risk groups for small bowel tumors, and surveillance programs for small bowel tumors are needed. VCE and radiological imaging have value in screening, and in selected cases, DAE can provide more accurate diagnosis and endoscopic treatment. This review describes the usefulness and clinical impact of VCE on small bowel tumors.
视频胶囊内镜检查(VCE)扩大了小肠内镜检查的范围。VCE的临床应用主要针对不明原因的胃肠道出血(OGIB),小肠肿瘤是VCE临床上重要的诊断之一,通常需要后续的侵入性干预。在OGIB、缺铁性贫血、不明原因腹痛等情况下,VCE检测小肠肿瘤的频率约为4%。小肠肿瘤的VCE表现包括有出血的突出肿块、黏膜破坏、表面不规则、变色区域和白色绒毛。器械辅助小肠镜检查(DAE)、计算机断层扫描小肠造影/小肠成像和磁共振小肠造影/小肠成像在小肠检查和肿瘤检测中也具有临床价值,它们可以与VCE顺序或互补使用。家族性腺瘤性息肉病、佩-吉综合征、黑色素瘤、淋巴瘤以及伴有肝转移的神经内分泌肿瘤是小肠肿瘤的高危人群,需要进行小肠肿瘤监测计划。VCE和放射影像学在筛查中具有价值,在某些选定病例中,DAE可以提供更准确的诊断和内镜治疗。本综述描述了VCE对小肠肿瘤的有用性和临床影响。