Background and study aims: Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have been introduced as modalities for examining the entire small bowel. The aim of the present study was to assess the clinical e...Background and study aims: Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have been introduced as modalities for examining the entire small bowel. The aim of the present study was to assess the clinical effects of CE and DBE to consider the roles of CE and DBE and the indications for the procedures in patients with suspected small-bowel bleeding. Patients and methods: Between June 2004 and January 2005,32 patients in whom a site of bleeding in the gastrointestinal tract had not been identified were enrolled in the study. Twenty-eight patients were examined with both methods. Bleeding sources were categorized as either A1 lesions (immediate hemostatic procedures required) or A2 lesions (close observation required). CE and DBE were evaluated with regard to whether or not they were capable of accessing the entire small bowel and provided a diagnosis, and the access and diagnostic rates were calculated. Results: On CE, 13 patients were diagnosed with A1 lesions and six with A2 lesions; on DBE, 11 had A1 lesions and one had an A2 lesion. The access rate for the entire small intestine on CE was 90.6% (29 of 32), significantly higher than with DBE at 62.5% (10 of 16; P < 0.05). The diagnostic rate on CE was 59.4% (19 of 32), higher than with DBE at 42.9% (12 of 28; P = 0.30), but not significantly different. Among patients with A1 lesions who were diagnosed with DBE, histological diagnoses were obtained in six of the 11, and three patients were treated. Conclusions: In many suspected small-bowel bleeding cases, CE should be selected for the initial diagnosis and DBE for treatment or histopathological diagnosis after detection of the bleeding site on展开更多
Background and Study Aim: Ensdoscopic ultrasound- gui- ded fine- needle aspiration (EUS- FNA) has been reported as a useful techni que for histological diagnosis of submucosal or extrinsic gastrointestinal and p ancre...Background and Study Aim: Ensdoscopic ultrasound- gui- ded fine- needle aspiration (EUS- FNA) has been reported as a useful techni que for histological diagnosis of submucosal or extrinsic gastrointestinal and p ancreatic lesions. The aim of this study was to evaluate the use of EUS- FNA fo r the diagnosis of lesions either within or adjacent to the wall of the colon an d rectum. Patients and Methods: A total of 22 patients with a lesion within the wall of, or adjacent to, the colon or rectum underwent EUS- FNA. They were divi ded into two groups: patients who had previously had a malignancy (the “ previo us + ve" group, n=11), and patients who had not previously had a malignancy (th e “ previous - ve" group, n = 11). In the four patients who had lesions locate d proximal to the sigmoid colon, EUS- FNA was performed using a guide wire and overtube. The success rates for adequate tissue sampling and for detecting malig nant and benign masses by EUS- FNA were evaluated and the success rate for dete ction was compared with the success rate of EUS and computed tomography. Results : Sufficient tissue for evaluation was obtained from 21 of be 22 patients (95.5 % ). The overall rate of detection of malignant and benign masses was 95.5% ( 21/22) for EUS- FNA and 81.8% (18/22) for pre- EUS- FNA imaging investigati ons. Of the 11 patients in the previous + ve group, ten were diagnosed with recurrences of primary malignancies; of the 11 patients in the previous - ve group, four we re diagnosed with primary malignancies and seven were diagnosed with benign lesi ons. There were no complications related to the EUS- FNA procedure. Conclusions : EUS- FNA is a safe techniquewhich is useful in the planning of treatment for patients who have a mass within the wall or adjacent to the wall of the entire l ength of the colon or rectum.展开更多
文摘Background and study aims: Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have been introduced as modalities for examining the entire small bowel. The aim of the present study was to assess the clinical effects of CE and DBE to consider the roles of CE and DBE and the indications for the procedures in patients with suspected small-bowel bleeding. Patients and methods: Between June 2004 and January 2005,32 patients in whom a site of bleeding in the gastrointestinal tract had not been identified were enrolled in the study. Twenty-eight patients were examined with both methods. Bleeding sources were categorized as either A1 lesions (immediate hemostatic procedures required) or A2 lesions (close observation required). CE and DBE were evaluated with regard to whether or not they were capable of accessing the entire small bowel and provided a diagnosis, and the access and diagnostic rates were calculated. Results: On CE, 13 patients were diagnosed with A1 lesions and six with A2 lesions; on DBE, 11 had A1 lesions and one had an A2 lesion. The access rate for the entire small intestine on CE was 90.6% (29 of 32), significantly higher than with DBE at 62.5% (10 of 16; P < 0.05). The diagnostic rate on CE was 59.4% (19 of 32), higher than with DBE at 42.9% (12 of 28; P = 0.30), but not significantly different. Among patients with A1 lesions who were diagnosed with DBE, histological diagnoses were obtained in six of the 11, and three patients were treated. Conclusions: In many suspected small-bowel bleeding cases, CE should be selected for the initial diagnosis and DBE for treatment or histopathological diagnosis after detection of the bleeding site on
文摘Background and Study Aim: Ensdoscopic ultrasound- gui- ded fine- needle aspiration (EUS- FNA) has been reported as a useful techni que for histological diagnosis of submucosal or extrinsic gastrointestinal and p ancreatic lesions. The aim of this study was to evaluate the use of EUS- FNA fo r the diagnosis of lesions either within or adjacent to the wall of the colon an d rectum. Patients and Methods: A total of 22 patients with a lesion within the wall of, or adjacent to, the colon or rectum underwent EUS- FNA. They were divi ded into two groups: patients who had previously had a malignancy (the “ previo us + ve" group, n=11), and patients who had not previously had a malignancy (th e “ previous - ve" group, n = 11). In the four patients who had lesions locate d proximal to the sigmoid colon, EUS- FNA was performed using a guide wire and overtube. The success rates for adequate tissue sampling and for detecting malig nant and benign masses by EUS- FNA were evaluated and the success rate for dete ction was compared with the success rate of EUS and computed tomography. Results : Sufficient tissue for evaluation was obtained from 21 of be 22 patients (95.5 % ). The overall rate of detection of malignant and benign masses was 95.5% ( 21/22) for EUS- FNA and 81.8% (18/22) for pre- EUS- FNA imaging investigati ons. Of the 11 patients in the previous + ve group, ten were diagnosed with recurrences of primary malignancies; of the 11 patients in the previous - ve group, four we re diagnosed with primary malignancies and seven were diagnosed with benign lesi ons. There were no complications related to the EUS- FNA procedure. Conclusions : EUS- FNA is a safe techniquewhich is useful in the planning of treatment for patients who have a mass within the wall or adjacent to the wall of the entire l ength of the colon or rectum.
