Impact of enteroscopy on diagnosis and management of small bowel tumors

Adriana Vaz Safatle-Ribeiro,Ulysses Ribeiro Jr.

doi:10.21147/j.issn.1000-9604.2020.03.04

Abstract

Small bowel tumors (SBTs) have been increasingly diagnosed in recent decades. The pathogenesis of this increment is largely unknown, but advances in radiological and endoscopic methods facilitate the improvement of the diagnosis. Capsule endoscopy (CE) and device-assisted enteroscopy (DAE) allow the clinician to assess the entire small bowel in the search for suspicious lesions, or a cause of symptoms. In this review, we discuss the role of enteroscopy, techniques and strategies in the diagnosis and management of SBTs, and a brief description of the most common tumors.

Highlights

Small intestine involves 70%−80% of the total length of the gastrointestinal tract, about 5−7 meters in length; neoplasms of this region are rare
There was an increase in the incidence of small bowel tumors (SBTs) over the last decade worldwide, probably due to the advances in radiological and endoscopic methods [3,4,5]
The purpose of this review is to describe the role of enteroscopy into the diagnosis and management of SBTs

Summary

Introduction

Small intestine involves 70%−80% of the total length of the gastrointestinal tract, about 5−7 meters in length; neoplasms of this region are rare. Hamartomatous polyps are considered benign lesions, they are associated with an increased risk of adenocarcinoma in the small intestine It is not known whether they originate from these or from associated adenomas (Figure 4A). DAE is indicated for resecting the lesions, decreasing the risk of short bowel syndrome due to multiple intestinal resections [70] Such strategy has a great impact for pediatric patients [71]. Celiac patients are considered a high-risk group for small bowel malignancies, including adenocarcinoma, and lymphoma. There is evidence that microbial and parasitic colonization of the small intestine is related to its pathogenesis since there is a response to antibiotic treatment in the early stage of the disease They can appear as diffuse nodular lesions (Figure 8) [95]. DAE can precisely locate and mark single or multiple lesions, guiding and modifying the surgical treatment [107] (Figure 10)

Limitations and complications

Findings

Conclusions