Sinha Ayusa, Johal Amitpal S, Khurana Ansh, Basi Puneet, Khara Harshit S
Division of Gastroenterology and Nutrition, Geisinger Health System, Danville, USA.
Department of Gastroenterology, UPMC Susquehanna Health, Williamsport, USA.
Cureus. 2020 Dec 7;12(12):e11962. doi: 10.7759/cureus.11962.
Hamartomatous polyps are gastrointestinal tumors that may present with small bowel obstruction requiring surgical resection, while others may present earlier as symptomatic anemia prior to becoming an obstructing mass. Video capsule endoscopy has enhanced the early detection of small bowel lesions. However, endoscopic interventions especially for distal small bowel lesions are limited due to long procedure times, technical challenges in achieving depth of insertion, and the requirement of specialized deep enteroscopy equipment with advanced endoscopy training, which are not always available. Therefore, surgical intervention is often required. NaviAid-assisted enteroscopy, a novel thorough-the-scope balloon, results in deep anterograde and retrograde intubation of the small intestine using standard colonoscope and can be used for rapid therapeutic intervention. We present two cases of distal small bowel hamartomas which were resected via retrograde NaviAid-assisted enteroscopy, thus, preventing surgery.
错构瘤性息肉是胃肠道肿瘤,可能表现为需要手术切除的小肠梗阻,而其他一些错构瘤性息肉可能在成为梗阻性肿块之前更早地表现为有症状的贫血。视频胶囊内镜检查提高了小肠病变的早期检测率。然而,内镜干预,特别是针对远端小肠病变的干预,由于操作时间长、插入深度的技术挑战以及需要配备先进内镜培训的专门深部小肠镜设备(而这些设备并非总是可用)而受到限制。因此,通常需要进行手术干预。NaviAid辅助小肠镜检查是一种新型的全程球囊,使用标准结肠镜可实现小肠的深部顺行和逆行插管,可用于快速治疗干预。我们报告了两例通过逆行NaviAid辅助小肠镜检查切除的远端小肠错构瘤病例,从而避免了手术。