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1.
Diagnostics (Basel) ; 12(5)2022 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-35626403

RESUMO

Background This study aims to explore a deep learning (DL) algorithm for developing a prognostic model and perform survival analyses in SBT patients. Methods The demographic and clinical features of patients with SBTs were extracted from the Surveillance, Epidemiology and End Results (SEER) database. We randomly split the samples into the training set and the validation set at 7:3. Cox proportional hazards (Cox-PH) analysis and the DeepSurv algorithm were used to develop models. The performance of the Cox-PH and DeepSurv models was evaluated using receiver operating characteristic curves, calibration curves, C-statistics and decision-curve analysis (DCA). A Kaplan-Meier (K-M) survival analysis was performed for further explanation on prognostic effect of the Cox-PH model. Results The multivariate analysis demonstrated that seven variables were associated with cancer-specific survival (CSS) (all p < 0.05). The DeepSurv model showed better performance than the Cox-PH model (C-index: 0.871 vs. 0.866). The calibration curves and DCA revealed that the two models had good discrimination and calibration. Moreover, patients with ileac malignancy and N2 stage disease were not responding to surgery according to the K-M analysis. Conclusions This study reported a DeepSurv model that performed well in CSS in SBT patients. It might offer insights into future research to explore more DL algorithms in cohort studies.

2.
Ann Med Surg (Lond) ; 66: 102355, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34040763

RESUMO

INTRODUCTION AND IMPORTANCE: Inflammatory fibroid polyps (IFPs) are rare, benign tumors that can arise throughout the gastrointestinal tract, they are usually asymptomatic, and clinical presentation depends on the site of involvement. Gastric and colon IFPs are traditionally identified incidentally, whereas small intestinal lesions are often encountered in the setting of intussusception or during imaging studies. Complete resection via endoscopy or surgery is recommended. CASE PRESENTATION: Patient is a 52-year-old male without past medical history; he had a five-month history of mild colicky abdominal pain. A mass was detected in the small bowel, and surgery was decided. Since the mass was small a cooperative approach with an intraoperative enteroscopy was needed to locate the mass and achieve complete resection. DISCUSSION: IFPs of the small bowel require complete resection. Surgery should be performed as early as possible to prevent complications like intussusceptions, ischemia, and necrosis. CONCLUSIONS: In these rare tumors, the collaboration between surgeons and endoscopists is indispensable to improve the patient's prognosis.

3.
Gastrointest Endosc Clin N Am ; 31(2): 277-306, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33743926

RESUMO

Video capsule endoscopy has an essential role in the diagnosis and management of small bowel bleeding and is the first-line study recommended for this purpose. This article reviews the risk factors for small bowel bleeding, optimal timing for video capsule endoscopy testing, and algorithms recommended for evaluation. Used primarily for the assessment of nonacute gastrointestinal blood loss, video capsule endoscopy has an emerging role for more urgent use in emergency settings and in special populations. Future software incorporation of neural networks to enhance lesion detection will likely result in an augmented role of video capsule endoscopy in small bowel bleeding.


Assuntos
Endoscopia por Cápsula , Intestino Delgado , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Humanos , Intestino Delgado/diagnóstico por imagem
4.
J Int Med Res ; 48(10): 300060520959489, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33050749

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of double-balloon endoscopy (DBE) for small bowel disease (SBD). METHODS: The clinical and endoscopic data of patients who underwent DBE in a Chinese tertiary hospital from January 2006 to December 2019 were retrospectively reviewed. The patients were divided into three groups by age: the young group (<45 years), middle-aged group (45-65 years), and older group (>65 years). RESULTS: In total, 1177 patients who underwent 2134 DBE procedures were included. The anterograde and retrograde route was used in 1111 and 1023 procedures, respectively. The most common reason for performing DBE was suspected small bowel bleeding (SSBB) (53.1%), and the most common SBD was Crohn's disease (CD) (18.1%). Hemostasis was the predominant endoscopic therapy (54.3%). The total complication rate was 0.8%. The incidence of CD was highest in the young group, and the incidence of tumors was highest in the older group; these findings were consistent both among the overall patient population and among patients with SSBB. CONCLUSIONS: DBE is effective and safe for the diagnosis and treatment of SBD and is considered to have great potential as a first-line method for diagnosing SBD.


Assuntos
Endoscopia Gastrointestinal , Enteropatias , Doença Aguda , China/epidemiologia , Enteroscopia de Duplo Balão , Feminino , Humanos , Enteropatias/diagnóstico , Intestino Delgado , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária
5.
Chin J Cancer Res ; 32(3): 319-333, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32694897

RESUMO

Small bowel tumors (SBTs) have been increasingly diagnosed in recent decades. The pathogenesis of this increment is largely unknown, but advances in radiological and endoscopic methods facilitate the improvement of the diagnosis. Capsule endoscopy (CE) and device-assisted enteroscopy (DAE) allow the clinician to assess the entire small bowel in the search for suspicious lesions, or a cause of symptoms. In this review, we discuss the role of enteroscopy, techniques and strategies in the diagnosis and management of SBTs, and a brief description of the most common tumors.

6.
J Gastrointest Cancer ; 51(3): 901-907, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31705396

RESUMO

INTRODUCTION: Small bowel is an uncommon site for primary neoplasm in the gastrointestinal tract. Traditionally, duodenum has been combined with jejunum and ileum in analysing the presentation and management of these tumors. Given the different presentation pattern, diagnostic difficulties and anatomical considerations, jejunal tumors may differ from duodenal tumors. METHODOLOGY: Retrospective analysis of a prospectively maintained database of patients with histology proven jejunal tumors was done. Clinico-radiological characters, histological findings, surgical procedures and the outcomes in these patients were studied. RESULTS: Sixteen patients were included in the study. Median age at presentation was 42 years (26-76 years) and majority were males (n = 11, 68.8%). Seven (43.7%) patients presented with emergencies. Endoscopic tissue diagnosis could be obtained in 5 (31.3%) patients. Histology of tumors were adenocarcinoma, gastrointestinal stromal tumor and lymphoma in 6 (37.5%), 5 (31.3%) and 3 (18.8%) respectively. Sarcoma (myxofibroma) and metastasis (urothelial origin) were present in one patient each. Two patients with adenocarcinoma had neoadjuvant chemotherapy. Curative resection was feasible in 14 patients. Resection of tumor-bearing segment with anastomosis was performed in 9 patients. Among these, 5 had duodenojejunostomy. One patient had resection and double-barrel jejunostomy. One patient with jejunal GIST had sleeve resection. Multi-visceral resection was performed in 3 patients. There were no mortality and median postoperative hospital stay was 11 days (range 7-33 days). CONCLUSION: Histology spectrum of jejunal tumors are distinct. Difficulty in obtaining preoperative tissue diagnosis of these lesions need to be addressed by improved endoscopic and image-directed biopsy techniques.


Assuntos
Adenocarcinoma/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Neoplasias Gastrointestinais/cirurgia , Tumores do Estroma Gastrointestinal/cirurgia , Neoplasias do Jejuno/cirurgia , Linfoma/cirurgia , Centros de Atenção Terciária , Adenocarcinoma/patologia , Adulto , Idoso , Anastomose Cirúrgica , Feminino , Seguimentos , Neoplasias Gastrointestinais/patologia , Tumores do Estroma Gastrointestinal/patologia , Humanos , Neoplasias do Jejuno/patologia , Linfoma/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos
7.
Dig Liver Dis ; 51(7): 934-943, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31138509

RESUMO

After more than 15 years since its introduction into clinical practice, indications for device-assisted enteroscopy have greatly expanded. Alongside the consolidated indications such as the diagnosis and treatment of small bowel bleeding, Crohn's disease, hereditary polyposis, small-bowel tumors and complicated celiac disease, device-assisted enteroscopy is nowadays largely used to perform endoscopic retrograde cholangiopancreatography in patients with altered anatomy, stent placement, retrieval of foreign bodies, direct insertion of jejunal feeding tubes, and in selected cases of incomplete colonoscopy. This has been made possible by the technical improvements of the enteroscopes and accessories and by the widespread use of the method. Device-assisted enteroscopy endotherapy currently offers a safe and effective alternative to major surgery and often represents the preferred option for treatment of small-bowel pathology. Its safety profile is favourable even in the elderly patient, provided that it is performed in high-volume and experienced centers. The evolution of the enteroscopy technique is a challenge for the future and could be facilitated by the new enteroscopes models. These prototypes need a thorough clinical and safety assessment especially for the complex therapeutic procedures. Large prospective, multicenter studies should be performed to assess whether the use of device-assisted enteroscopy leads to improved patients' long-term outcomes.


Assuntos
Endoscopia Gastrointestinal/métodos , Gastroenteropatias/diagnóstico por imagem , Gastroenteropatias/terapia , Intestino Delgado/diagnóstico por imagem , Enteroscopia de Balão/métodos , Endoscopia por Cápsula/efeitos adversos , Endoscopia por Cápsula/métodos , Doença Celíaca/diagnóstico por imagem , Doença Celíaca/terapia , Colangiopancreatografia Retrógrada Endoscópica/métodos , Contraindicações de Procedimentos , Doença de Crohn/diagnóstico por imagem , Doença de Crohn/terapia , Endoscopia Gastrointestinal/efeitos adversos , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/terapia , Humanos , Neoplasias Intestinais/diagnóstico por imagem , Neoplasias Intestinais/terapia , Síndrome de Peutz-Jeghers/diagnóstico por imagem , Síndrome de Peutz-Jeghers/terapia
8.
Abdom Radiol (NY) ; 44(7): 2337-2345, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30877330

RESUMO

Since a broad spectrum of tumors can occur in the small bowels, it is not easy to make a correct differential diagnosis among small bowel tumors on CT findings. Therefore, once a mass is detected on CT, the radiologist needs to analyze the mass based on presenting patterns such as location, multiplicity, morphology, and enhancement patterns. In this article, we will illustrate various kinds of small bowel tumors based on imaging patterns at CT to facilitate making a correct diagnosis.


Assuntos
Neoplasias Intestinais/diagnóstico por imagem , Neoplasias do Jejuno/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Diagnóstico Diferencial , Humanos , Íleo/diagnóstico por imagem , Jejuno/diagnóstico por imagem
9.
Abdom Radiol (NY) ; 44(6): 2089-2103, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30809694

RESUMO

Although the small intestine accounts for over 90% of the surface area of the alimentary tract, tumors of the small intestine represent less than 5% of all gastrointestinal tract neoplasms. Common small bowel tumors typically are well evaluated with cross-sectional imaging modalities such as CT and MR, but accurate identification and differentiation can be challenging. Differentiating normal bowel from abnormal tumor depends on imaging modality and the particular technique. While endoscopic evaluation is typically more sensitive for the detection of intraluminal tumors that can be reached, CT and MR, as well as select nuclear medicine studies, remain superior for evaluating extraluminal neoplasms. Understanding the imaging characteristics of typical benign and malignant small bowel tumors is critical, because of overlapping features and associated secondary complications.


Assuntos
Neoplasias Intestinais/diagnóstico por imagem , Intestino Delgado , Imagem Multimodal , Meios de Contraste , Diagnóstico Diferencial , Humanos , Sensibilidade e Especificidade
11.
Gastroenterol Hepatol ; 41(10): 663-669, 2018 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30055860

RESUMO

Video capsule endoscopy (VCE) is a reliable noninvasive method for examination of small-bowel mucosa. However, it has some limitations. The aim of this article was to review the approach in patients with negative VCE. It is clear that a negative VCE should be interpreted based on the indication. In suspected small bowel bleeding (SSBB), patients with ongoing/recurrent overt bleeding, or occult bleeders who experience significant declines in hemoglobin after a negative VCE should proceed small bowel study; on the other hand, patients with occult SSBB and only mild-moderate anemia should be managed with supportive care. In inflammatory bowel disease, a normal VCE has a very high sensitivity and negative predictive value. In small bowel tumor suspicion there is a high risk of false negative results, so another imaging modality should be considered. In polyposis syndromes, if VCE is negative, patients should continue screening within 2-3 years.


Assuntos
Endoscopia por Cápsula , Enteropatias/diagnóstico por imagem , Catárticos , Reações Falso-Negativas , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/diagnóstico por imagem , Enteropatias/diagnóstico , Mucosa Intestinal/diagnóstico por imagem , Neoplasias Intestinais/diagnóstico , Neoplasias Intestinais/diagnóstico por imagem , Pólipos Intestinais/diagnóstico , Pólipos Intestinais/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem
12.
Intern Med ; 57(9): 1209-1212, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29279517

RESUMO

Objective The aim of the present study is to investigate the role of double-balloon enteroscopy in the diagnosis and surgical treatment of metastatic small bowel tumors. Patients We retrospectively reviewed the records of 13 patients with metastatic small bowel tumors among 376 patients who underwent double-balloon enteroscopy from June 2005 to March 2017 in our hospital. Results The primary lesion sites were the lung (n=9), kidney (n=2), stomach (n=1) and duodenum (n=1). The clinical presentations were anemia requiring blood transfusion (n=10), obstructive symptoms (n=2), and no symptoms (n=1). The locations of the metastatic small bowel tumors were the jejunum (n=7), ileum (n=1), and both sites (n=5). The histological diagnosis of the metastatic tumor was made from biopsy specimens taken with double-balloon enteroscopy from all 11 patients whose condition permitted a biopsy. In seven patients, the findings on double-balloon endoscopy were determinants of the kind and extent of surgical treatment performed. Four patients had multiple metastatic small bowel tumors, and all were able to be removed surgically with guidance from preoperative tattooing at double-balloon endoscopy. After operation, blood transfusions were no longer needed in four of six patients who had required preoperative transfusions for the treatment of anemia, and one patient with intestinal obstructive symptoms was able to resume oral intake. Conclusion Double-balloon endoscopy was useful for making a histological diagnosis and directing surgical treatment in patients with metastatic small bowel tumors. Surgical treatment afforded palliation of symptoms in five patients.


Assuntos
Enteroscopia de Duplo Balão/métodos , Neoplasias do Íleo/diagnóstico , Neoplasias do Íleo/cirurgia , Neoplasias do Jejuno/diagnóstico , Neoplasias do Jejuno/cirurgia , Idoso , Biópsia , Feminino , Humanos , Neoplasias do Íleo/patologia , Neoplasias do Jejuno/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estudos Retrospectivos
13.
Gastrointest Endosc Clin N Am ; 27(1): 93-112, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27908521

RESUMO

The incidence of small bowel tumors is increasing over time. Until recently, their diagnosis was delayed and it was often reached only at the time of surgery. New diagnostic tools, such as capsule endoscopy, device-assisted enteroscopy, and dedicated small bowel cross-sectional imaging techniques, have been introduced recently in clinical practice. The combination of these tools allows medical practitioners to detect small bowel tumors at an early stage and to reach a definite diagnosis before surgery, thus enabling minimally invasive treatments.


Assuntos
Enteroscopia de Balão/métodos , Endoscopia por Cápsula , Neoplasias Intestinais/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Humanos
14.
Gastroenterology Res ; 10(6): 366-368, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29317945

RESUMO

Small intestinal tumors are rare with adenocarcinoma of the small intestine accounting for less than 2% of all gastrointestinal cancers. Primary jejunal adenocarcinoma constitutes a minute portion of small intestine adenocarcinomas. Clinically, this cancer presents at latter stages of its progression, mainly due to vague and non-specific symptoms, and the difficulty encountered in accessing the jejunum on upper endoscopy. Diagnosis of jejunal adenocarcinoma is usually inconclusive with the use of computed tomography (CT) scan, small bowel series, or upper endoscopy. Laparoscopy followed by frozen section biopsy provides a definitive diagnosis. In the past decade, balloon-assisted enteroscopy (BAE) and capsule endoscopy have become popular as useful modalities for diagnosing small bowel diseases. Wide excisional jejunectomy is the only treatment option with an estimated 5-year survival of 40-65%. Physicians are advised to suspect jejunal adenocarcinoma as a differential diagnosis in patients who present with non-specific symptoms of abdominal pain, nausea, vomiting, weight loss, anemia, gastrointestinal bleeding or signs of small bowel obstruction. We present a rare case of a 37-year-old woman with suspected bilateral ovarian masses, which was immunohistochemically confirmed as primary jejunal adenocarcinoma with bilateral ovarian metastasis.

15.
Curr Gastroenterol Rep ; 18(5): 23, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27086004

RESUMO

The small intestine is a relatively privileged organ that only rarely develops malignant or even benign tumors. Given this rarity, the relative inaccessibility of the organ during routine endoscopic procedures, and the typical absence or nonspecific nature of clinical manifestations, these tumors often go undiagnosed. Treatment and prognosis are tailored to each histological subtype of tumor. This chapter will discuss the epidemiology, presentation, diagnostics, and management for the most common small bowel tumors, and will highlight the importance of recognizing patients at higher risk of small bowel neoplasia.


Assuntos
Intestino Delgado , Humanos , Neoplasias Intestinais/diagnóstico , Neoplasias Intestinais/epidemiologia , Neoplasias Intestinais/terapia , Pólipos Intestinais/diagnóstico , Pólipos Intestinais/epidemiologia , Pólipos Intestinais/terapia
16.
Intern Emerg Med ; 10(7): 781-5, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26350281

RESUMO

Intestinal tumors represent less than 6% of digestive tumors, and, because of the limitations of intestinal investigations, these tumors are difficult to diagnose. In this context, capsule endoscopy has proven effective, especially in patients with obscure digestive bleeding. In a large series of patients undergoing capsule endoscopy, small bowel tumors are found in 2.4-8.9% of cases. The aim of this retrospective, single-center study, based on prospective database, is to evaluate the frequency of small bowel tumors detected by capsule endoscopy in patients with occult gastrointestinal bleeding. During 2004-2014, 849 consecutive patients underwent CE at our Department for occult gastrointestinal bleeding. Following capsule endoscopy, the medical records of the study population were reviewed. Results of double-balloon enteroscopy or surgery performed after capsule endoscopy were retrieved. Capsule endoscopy identified 55 small bowel tumors (6.5%), of which 28 malignancies (51%) and 27 benign neoplasms (49%) underwent surgery or endoscopic treatment. Malignancies included adenocarcinoma (18.7%), gastrointestinal stromal tumors (GIST) (12%) and lymphoma (6.7%). Benign neoplasms included dysplastic adenomatous polyps (36%) and hyperplastic polyps (25.3%). Non-neoplastic masses included one inflammatory polyp. Capsule retention occurred in four patients (5.3%) and the retained capsule was retrieved during surgery. In our experience neoplasms of small bowel are found in 6.5% of patients with occult gastrointestinal bleeding. Of these malignancies, small bowel neoplasms are found in 3.3% of cases. Capsule endoscopy is an effective and sensitive diagnostic tool, and plays an important role in the algorithm for the diagnostic workup of suspected small bowel tumors.


Assuntos
Endoscopia por Cápsula/normas , Hemorragia Gastrointestinal/diagnóstico , Neoplasias Intestinais/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Endoscopia por Cápsula/métodos , Hemorragia Gastrointestinal/etiologia , Humanos , Neoplasias Intestinais/complicações , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos
17.
World J Gastrointest Endosc ; 7(6): 652-8, 2015 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-26078833

RESUMO

AIM: To assess the double-balloon enteroscopy (DBE) role in malignant small bowel tumors (MSBT). METHODS: This is a retrospective descriptive study performed in a single center. All consecutive patients who underwent a DBE with final diagnosis of a malignant neoplasm from 2004 to 2014 in our referral center were included. Patient demographic and clinical pathological characteristics were recorded and reviewed. MSBT diagnosis was achieved either by DBE directed biopsy with multiple tissue sampling, endoscopic findings or histological analysis of surgical specimen. We have analyzed double-balloon enteroscopy impact in outcome and clinical course of these patients. RESULTS: Of 627 patients, 28 (4.5%) (mean age = 60 ± 17.3 years) underwent 30 procedures (25 anterograde, 5 retrograde) and were diagnosed of a malignant tumor. Patients presented with obscure gastrointestinal bleeding (n = 19, 67.9%), occlusion syndrome (n = 7, 25%) and diarrhea (n = 1, 3.6%). They were diagnosed by DBE biopsy (n = 18, 64.3%), histological analysis of surgical specimen (n = 7, 25%) and unequivocal endoscopic findings (n = 2, 7.1%). Gastrointestinal stromal tumor (n = 8, 28.6%), adenocarcinoma (n = 7, 25%), lymphoma (n = 4, 14.3%), neuroendocrine tumor (n = 4, 14.3%), metastatic (n = 3, 10.7%) and Kaposi sarcoma (n = 1, 3.6%) were identified. DBE modified outcome in 7 cases (25%), delaying or avoiding emergency surgery (n = 3), modifying surgery approach (n = 2) and indicating emergency SB partial resection instead of elective approach (n = 2). CONCLUSION: DBE may be critical in the management of MSBT providing additional information that may be decisive in the clinical course of these patients.

18.
World J Gastroenterol ; 20(42): 15664-73, 2014 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-25400450

RESUMO

Wireless capsule endoscopy (CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal (GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology.


Assuntos
Endoscopia por Cápsula , Hemorragia Gastrointestinal/diagnóstico , Intestino Delgado/patologia , Tecnologia sem Fio , Animais , Biópsia , Cápsulas Endoscópicas , Endoscopia por Cápsula/instrumentação , Endoscopia por Cápsula/métodos , Endoscopia por Cápsula/tendências , Difusão de Inovações , Desenho de Equipamento , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/patologia , Humanos , Valor Preditivo dos Testes , Fatores de Risco , Tecnologia sem Fio/instrumentação , Tecnologia sem Fio/tendências
19.
World J Radiol ; 6(8): 544-66, 2014 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-25170393

RESUMO

Over the past two decades, advances in cross-sectional imaging such as computed tomography and magnetic resonance imaging (MRI) have dramatically changed the concept of gastrointestinal imaging. MR is playing an increasing role in the evaluation of gastrointestinal disorders. MRI combines the advantages of excellent soft-tissue contrast, noninvasiveness, functional information and lack of ionizing radiation. Furthermore, recent developments of MRI have led to improved spatial and temporal resolution as well as decreased motion artifacts. In this article we describe the technical aspects of gastrointestinal MRI and present a practical approach for a well-known spectrum of gastrointestinal disease processes.

20.
Gastroenterol Rep (Oxf) ; 2(2): 150-3, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24759341

RESUMO

Small bowel malignant tumors are rare and sarcomatoid carcinomas have rarely been reported at this site. We report a 56-year-old woman, with history of an excised gliosarcoma, who presented with recurrent obscure gastrointestinal bleeding. She underwent endoscopy and colonoscopy, which failed to identify the cause of the bleeding. The abdominal computed tomography scan located a tumor in the small bowel. Pathology revealed a jejunal sarcomatoid carcinoma. She developed tumor recurrence and multiple liver metastases shortly after surgery. Immunohistochemistry is required for accurate diagnosis. Sarcomatoid carcinoma is a rare cause of obscure gastrointestinal bleeding, which is associated with a poor prognosis.

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