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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 14, 2008; 14(34): 5245-5253
Published online Sep 14, 2008. doi: 10.3748/wjg.14.5245
Capsule endoscopy in neoplastic diseases
Marco Pennazio, Emanuele Rondonotti, Roberto de Franchis
Marco Pennazio, Division of Gastroenterology 2, Department of Gastroenterology and Clinical Nutrition, S. Giovanni A.S. Hospital, Via Cavour 31, Turin 10123, Italy
Emanuele Rondonotti, Roberto de Franchis, University of Milan, IRCCS Policlinico, Mangiagalli, Regina Elena Foundation, Gastroenterology and Gastrointestinal Endoscopy Unit, Via Pace 9, Milan 20100, Italy
Correspondence to: Dr. Marco Pennazio, Division of Gastroenterology 2, Department of Gastroenterology and Clinical Nutrition, S. Giovanni A.S. Hospital, Via Cavour 31, Turin 10123, Italy. pennazio.marco@gmail.com
Telephone: +39-11-6333594 Fax: +39-11-6333623
Received: February 15, 2007
Revised: July 26, 2008
Accepted: August 2, 2008
Published online: September 14, 2008
Abstract

Until recently, diagnosis and management of small-bowel tumors were delayed by the difficulty of access to the small bowel and the poor diagnostic capabilities of the available diagnostic techniques. An array of new methods has recently been developed, increasing the possibility of detecting these tumors at an earlier stage. Capsule endoscopy (CE) appears to be an ideal tool to recognize the presence of neoplastic lesions along this organ, since it is non-invasive and enables the entire small bowel to be visualized. High-quality images of the small-bowel mucosa may be captured and small and flat lesions recognized, without exposure to radiation. Recent studies on a large population of patients undergoing CE have reported small-bowel tumor frequency only slightly above that reported in previous surgical series (range, 1.6%-2.4%) and have also confirmed that the main clinical indication to CE in patients with small-bowel tumors is obscure gastrointestinal (GI) bleeding. The majority of tumors identified by CE are malignant; many were unsuspected and not found by other methods. However, it remains difficult to identify pathology and tumor type based on the lesion’s endoscopic appearance. Despite its limitations, CE provides crucial information leading in most cases to changes in subsequent patient management. Whether the use of CE in combination with other new diagnostic (MRI or multidetector CT enterography) and therapeutic (Push-and-pull enteroscopy) techniques will lead to earlier diagnosis and treatment of these neoplasms, ultimately resulting in a survival advantage and in cost savings, remains to be determined through carefully-designed studies.

Keywords: Capsule endoscopy; Enteroscopy; Obscure gastrointestinal bleeding; Small-bowel tumors; Polyposis syndromes