Asunto(s)
Leiomioma/patología , Neoplasias Gástricas/patología , Adolescente , Biopsia , Duodenoscopía , Esofagectomía , Gastrectomía , Gastroscopía , Humanos , Laparoscopía , Leiomioma/diagnóstico por imagen , Leiomioma/cirugía , Masculino , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/cirugía , Carga TumoralRESUMEN
PURPOSE OF REVIEW: Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special attention for vascular and ulcerative lesions, to provide the reader with a clinical guide and flow chart towards SB bleeding. RECENT FINDINGS: Absence of SB bleeding lesions on CE does not directly yield better prognosis; although having a lower rebleeding rate the first 2 years, rebleeding in the long term is high. Push enteroscopy can play an early role in patients with SB bleeding if suspicion of angioectasia is high, since these lesions tend to be located in the proximal SB. Endoscopic management of angioectasia is, however, difficult and shows poor results. Capsule endoscopy (CE) or device-assisted enteroscopy (DAE) remain the diagnostic mainstay in SB bleeding, choosing one over the other based upon patient characteristics and expected lesions.
Asunto(s)
Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Enfermedades Intestinales/diagnóstico , Enfermedades Intestinales/terapia , Factores de Edad , Endoscopía Capsular , Endoscopía Gastrointestinal , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/diagnóstico por imagen , Humanos , Enfermedades Intestinales/complicaciones , Enfermedades Intestinales/diagnóstico por imagen , Intestino Delgado/irrigación sanguínea , Intestino Delgado/diagnóstico por imagen , Imagen por Resonancia Magnética , Cintigrafía , Factores de Riesgo , Tomografía Computarizada por Rayos XAsunto(s)
Yeyuno/patología , Extremidad Inferior/fisiopatología , Linfangiectasia Intestinal/diagnóstico , Linfangiectasia Intestinal/patología , Diagnóstico Diferencial , Humanos , Hipoalbuminemia/diagnóstico , Linfedema/diagnóstico , Masculino , Persona de Mediana Edad , Papiloma/diagnóstico , Enteroscopia de Balón IndividualAsunto(s)
Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Mesotelioma/complicaciones , Mesotelioma/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Disnea/diagnóstico por imagen , Disnea/etiología , Femenino , Neoplasias Cardíacas/terapia , Humanos , Mesotelioma/terapia , Persona de Mediana Edad , Pericardio , Tomografía de Emisión de PositronesRESUMEN
The development of capsule endoscopy (CE) in 2001 has given gastroenterologists the opportunity to investigate the small bowel in a non-invasive way. CE is most commonly performed for obscure gastrointestinal bleeding, but other indications include diagnosis or follow-up of Crohn's disease, suspicion of a small bowel tumor, diagnosis and surveillance of hereditary polyposis syndromes, Nonsteroidal anti-inflammatory drug-induced small bowel lesions and celiac disease. Almost fifteen years have passed since the release of the small bowel capsule. The purpose of this review is to offer the reader a brief but complete overview on small bowel CE anno 2014, including the technical and procedural aspects, the possible complications and the most important indications. We will end with some future perspectives of CE.