M1108 Capsule Endoscopy Is Useful and Safe for Small Bowel Surveillance in Familial Adenomatous Polyposis

Abstract

Results: Eleven of 23 patients with FAP had duodenal polyps. During CE, jejunal-ileal polyps were detected in 7 of 23 FAPs, with a total number of 15 polyps in the ileum. The presence of duodenal adenomas was the only clinical feature predictive of small-bowel polyps. Identification of the ampulla of Vater was not achieved with CE; duodenal polyps were only seen in 4 of 11 patients identified endoscopically, with an underestimation of polyp numbers. APC mutations between codons 499 and 805 were associated with the absence of small-bowel polyps. Conclusions: CE is useful and safe for the surveillance of jejunal-ileal polyps in selected patients with FAP. CE is not useful in the surveillance of the duodenum where the majority of small-bowel cancers occur. (Gastrointest Endosc 2008;67:61-7.) Familial adenomatous polyposis (FAP) is an inherited autosomal dominant disease; the gene locus is on chromosome 5q21. 1-3 The disease is characterized by adenomatous polyps in the large and small bowels and is associated with a virtual 100% risk of colorectal cancer.