Frequency of Small Bowel Polyps in Patients with Duodenal Adenoma but without Familial Adenomatous Polyposis

Zusammenfassung

Einleitung: Bisher ist unklar, ob Patienten mit Duodenaladenomen ohne Nachweis einer FAP ein erhöhtes Risiko für die Entwicklung von Dünndarmneoplasien aufweisen. Wir untersuchten daher eine Kollektiv von Patienten mit nicht FAP-assoziierten Duodenaladenomen mit der Kapselendoskopie. Patienten und Methoden: 14 Patienten (8 Frauen, 6 Männer; mittl. Alter 67 ± 10 Jahre) mit nachgewiesenen nicht papillären Duodenaladenomen unterzogen sich einer Dünndarmuntersuchung mittels Kapselendoskopie. Die Ergebnisse wurden mit einer altersentsprechenden Kontrollgruppe, die die Kapselendoskopie aus anderen Indikationen erhielt, verglichen. Ergebnisse: Insgesamt detektierte die Kapsel in der Studiengruppe 15 Polypen mit einem Durchmesser von 1 bis 8 mm. Im Gegensatz konnten in der Kontrollgruppe keine Polypen nachgewiesen werden. Komplikationen traten nicht auf. Zusätzliche Befunde waren multiple Angiodysplasien bei 2 Patienten der Studiengruppe. In der Kontrollgruppe detektierte die Kapselendoskopie Angiodysplasien bei 5 Patienten mit der Indikation obskure gastrointestinale Blutung und entzündliche Läsionen bei 2 Patienten mit dem V.a. auf einen M. Crohn. Diskussion: Die Ergebnisse unserer Studie zeigen, das Patienten mit nachgewiesenen Duodenaladenomen im Vergleich zu einer Kontrollgruppe häufiger Dünndarmpolypen aufweisen. Diese bedurften in unserem Patientenkollektiv keiner weiteren Therapie. Follow-up-Daten sind jedoch notwendig.

Abstract

Introduction: It is uncertain whether patients with duodenal adenomas without familial adenomatous polyposis (FAP) are at greater risk for small bowel neoplasia. We therefore conducted a study to determine the frequency of small bowel polyps in patients with non-papillary duodenal adenomas using capsule endoscopy for small bowel examination. Patients and Methods: 14 patients (8 women, 6 men; mean age 67 ± 10 years; range: 49 - 77 years) with non-papillary duodenal adenomas without FAP were included. All patients underwent wireless capsule endoscopy. The results were compared with an age- and sex-matched cohort of patients undergoing capsule endoscopy for suspected small bowel disease. Results: Overall, 15 polyps ranging between 1 and 8 mm in diameter were detected in eight patients of the study group, whereas no polyps could be identified in the control group. Natural excretion of the capsule within 24 hours was always reported and no complications were reported by any of the patients. Other pathological findings were multiple angiodysplasias in two patients of the study group. In the control group capsule endoscopy detected angiodysplasias in 5 patients with the indication obscure gastrointestinal bleeding, and inflammatory lesions in 2 patients with suspected Crohn’s disease. Conclusions: Based on the results of this prospective study, the frequency of small bowel polyps in patients with duodenal adenomas without familial adenomatous polyposis appears to be increased compared with a control group undergoing capsule endoscopy for other reasons. In none of the patients was the management altered. Follow-up data of these patients will be needed.

Schlüsselwörter

Kapselendoskopie - Duodenaladenom - Dünndarmpolypen

Key words

Capsule endsocopy - duodenal adenoma - small bowel polyps

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