small bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter european study

Background: small bowel (SB) tumors account for 1-3% of all GI neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previusly reported.Aim of the study: to evaluate frequency, clinical presentation, diagnostic/therapeutic work-up and endoscopic appearance of SB tumors in a large population of patients undergoing VCE.Methods: identification by specific questionnaire of all patients with VCE findings suggesting SB tumors and histological confirmation of the neoplasm seen in 29 centers of 10 European counries Results:124/5129 patients undergoing VCE (2.4%) had SB tumors (112 primitive,12 metastatic).Indication for VCE: obscure GI bleeding (108 patients), abdominal pain (9), research for primitive neoplasm (6), diarrhea with malabsorption (1). 80.6% of the tumors were identified solely based on VCE findings. 55 patients underwent VCE as the thierd procedure after a negative bidiretional endoscopy; 69 underwent a mean of 1.47 examinations before VCE. the lesions were single in 89.5% of cases, multiple in 10.5%. VCE retention occurred in 9.8% of patients. After VCE, 54 patients underwent 57 other examinations before treatment. The diagnostic yield of enteroscopy performed before VCE was 9%, compared with 77% when performed after a positive VCE examination (p<0.0001). Treatment was surgery in 92% of cases. Conclusions: In our series the frequency of SB tumors was 2.4%.The majority of patients had obscure GI bleeding.VCE results led directly to treatment in 47% of patients, and oriented the subsequent endoscopic work up in 28%.