Endoscopy 2020; 52(S 01): S38-S39
DOI: 10.1055/s-0040-1704120
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 08:30 – 10:00 Take a pill Wicklow Meeting Room 3
© Georg Thieme Verlag KG Stuttgart · New York

THE PREVALENCE OF SMALL BOWEL POLYPS ON VIDEO CAPSULE ENDOSCOPY IN PATIENTS WITH SPORADIC DUODENAL AND/OR AMPULLARY ADENOMAS

H Awadie
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
,
A Klein
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
,
D Tate
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
,
B Jideh
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
,
I Bar Yishay
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
,
K Goodrick
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
,
G Ahlenstiel
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
2   The University of Sydney, Sydney, Australia
,
MJ Bourke
1   Westmead Hospital, Gastroenterology and Hepatology Department, Westmead, Australia
2   The University of Sydney, Sydney, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Sporadic duodenal and/or ampullary adenomas (DA) are found in 1-3% of patients referred to upper endoscopy. Patients with duodenal adenomas have a 3-7-fold increased risk of colonic neoplasia. It is unknown whether DA patients have a clinically significant increased risk of small bowel neoplasia. Our aim was to investigate the prevalence of SB polyps occurring in association with large (≥10mm) DA patients using VCE.

Methods In a single centre, prospective case control study, we used video capsule endoscopy (VCE) to investigate the prevalence of SB polyps in patients with a large(≥10mm) DA compared to patients undergoing VCE for obscure gastrointestinal bleeding (OGIB) or iron deficiency anaemia (IDA).

Results Over 25 months, 201 patients were enrolled in the study. The mean age was 65 and 47% were male. There were 101 control patients and 100 DA cases (mean size 30mm,(range 10-80mm)) .

Five patients (DA group) were excluded from analysis due to inadvertent aspiration of the capsule (1), technical failure (2), inability to swallow the capsule (1) and non-adenomatous lesion (1).

There were no SB polyps in either group. One DA patient had an incidental finding of active bleeding, most likely from an angiodysplasia, but otherwise no significant small bowel findings were obtained.

Colonic polyps were found more frequently in the DA group than controls (61% vs 41%, respectively (p-0.002)). Overall, 46% of patients in the DA group had at least one colonic adenoma vs. 27% in the control group (p-0.011) (Table-1). Advanced colonic polyps (HGD, >10mm, Villous histology) were found in 22% and 12% of the DA and control group, respectively (p-0.021).

Conclusions Our data suggests that patients with a DA are not at risk for synchronous SB polyps and hence does not support screening with VCE. However, colonoscopy is mandatory due to the significantly higher risk of colonic polyps including advanced adenomas