THE ROLE OF CAPSULE ENDOSCOPY IN THE SMALL BOWEL TUMOURS – A LARGE SINGLE CENTRE EXPERIENCE

Aims:

The frequency of small bowel tumours in capsule endoscopy (CE) ranges from 2.4% to 9.5% for all indications. This study was aimed to evaluate the role of capsule endoscopy in the management of small bowel tumours.

Methods:

The medical records of the patients from Jan 2003 to Oct 2017, who underwent capsule endoscopy at Asian Institute of Gastroenterology, Hyderabad, India were reviewed. The Video Capsule Endoscopy system of Given Imaging (Yoqneam, Israel) was used in all cases.

Results:

Overall, 1694 CE examinations were performed during study period. 5.7% (n = 98) CE examinations were positive for small bowel tumors. 73.5% (72 of 98) underwent CE for obscure GI bleed and remaining 26.5% (26 of 98) for abdominal pain. Most common small bowel tumours were polyps – 53.1% (52 of 98; out of which six werePeutz-Jeghers syndrome); followed by GIST – 19.4% (19 of 98), carcinoids – 10.2% (10 of 98), lymphoma – 9.2% (9 of 98) and adenocarcinoma were 4.1% (4 of 98). Less than 1% patients had retention of CE. Eighty two out of 98 patients had radiological imaging before CE; out of which 34 (41.5%) were positive. 36 (36.7%) patients underwent surgical resection.

Conclusions:

Small bowel tumours can be detected by capsule endoscopy; which are often missed by prior radiological imaging. CE can alter clinical decision and management in such cases.