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Endoscopy 2008; 40(6): 488-495
DOI: 10.1055/s-2007-995783
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study

E.  Rondonotti1 , M.  Pennazio2 , E.  Toth3 , P.  Menchen4 , M.  E.  Riccioni5 , G.  D.  De Palma6 , F.  Scotto7 , D.  De Looze8 , T.  Pachofsky9 , I.  Tacheci10 , T.  Havelund11 , G.  Couto12 , A.  Trifan13 , A.  Kofokotsios14 , R.  Cannizzaro15 , E.  Perez-Quadrado16 , R.  de Franchis1 on behalf of the European Capsule Endoscopy Group (ECEG), the Italian Club for Capsule Endoscopy (CICE) and the Iberian Group for Capsule Endoscopy (IGCE). Also see Appendix for additional contributors.
  • 1Department of Internal Medicine, Gastroenterology 3 Unit, University of Milan, IRCCS Policlinico, Mangiagalli and Regina Elena Foundation, Milan, Italy
  • 2Department of Gastroenterology and Clinical Nutrition, S. Giovanni AS Hospital, Turin, Italy
  • 3Endoscopy Unit, Department of Medicine, Malmo University Hospital, Malmo, Sweden
  • 4Endoscopy Unit, Gregorio Maranon University Hospital, Madrid, Spain
  • 5Unità Operativa di Endoscopia Digestiva e Chirurgica, Dipartimento di Scienze chirurgiche, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
  • 6Department of Surgery and Advanced Technologies, School of Medicine, University of Naples Federico II, Naples, Italy
  • 7Unità Operativa di Gastroenterologia ed Endoscopi Digestiva Istituto Tumori Giovanni Paolo II, Bari, Italy
  • 8Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
  • 9Gastroenterology Unit, Krankenanstalt Rudolfstiftung, Vienna, Austria
  • 10Second Department of Internal Medicine, Faculty of Medicine and Teaching Hospital, Charles University, Hradec Kralove, Czech Republic
  • 11Gastroenterology Unit, Department of Internal Medicine, Odense University Hospital, Odense, Denmark
  • 12Servicio de Gastroenterologia, Hospital de Egas Moniz, Lisbon, Portugal
  • 13Gastroenterology Unit, Institute of Gastroenterology and Hepatology, Iasi, Romania
  • 14Department of Gastroenterology, Euromedica Geniki Clinici Thessalonikis Thessalonika, Grece
  • 15Unità Operativa di Gastroenterologia, Centro di Riferimento Oncologico, Aviano, Italy
  • 16Small Bowel Unit, Hospital Morales Meseguer, Murcia, Spain
Further Information

Publication History

submitted 4 September 2007

accepted after revision 16 January 2008

Publication Date:
08 May 2008 (online)

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Commentaire de travail de E. Rondonotti et al., pp. 488Endoscopy 2008; 40(06): 545-545
DOI: 10.1055/s-0032-1306843

Background and study aim: Small-bowel tumors account for 1 % - 3 % of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency, clinical presentation, diagnostic/therapeutic work-up, and endoscopic appearance of small-bowel tumors in a large population of patients undergoing VCE.

Patients and methods: Identification by a questionnaire of patients with VCE findings suggesting small-bowel tumors and histological confirmation of the neoplasm seen in 29 centers of 10 European Countries.

Results: Of 5129 patients undergoing VCE, 124 (2.4 %) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm (6), diarrhea with malabsorption (1). The main primary small-bowel tumor type was gastrointestinal stromal tumor (GIST) (32 %) followed by adenocarcinoma (20 %) and carcinoid (15 %); 66 % of secondary small-bowel tumors were melanomas. Of the tumors, 80.6 % were identified solely on the basis of VCE findings. 55 patients underwent VCE as the third procedure after negative bidirectional endoscopy. The lesions were single in 89.5 % of cases, and multiple in 10.5 %. Retention of the capsule occurred in 9.8 % of patients with small-bowel tumors. After VCE, 54/124 patients underwent 57 other examinations before treatment; in these patients enteroscopy, when performed, showed a high diagnostic yield. Treatment was surgery in 95 % of cases.

Conclusions: Our data suggest that VCE detects small-bowel tumors in a small proportion of patients undergoing this examination, but the early use of this tool can shorten the diagnostic work-up and influence the subsequent management of these patients.

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E. Rondonotti, MD 

Università degli Studi di Milano
IRCCS Fondazione Policlinico, Mangiagalli, Regina Elena
Dipartimento di Scienze Mediche
Unità Operativa Gastroenterologia 3

Via Pace 9
20122 Milano
Italy

Fax: +39-02-50320747

Email: emanuele.rondonotti@unimi.it