Clinical profile associated with bleeding small bowel tumors in patients undergoing capsule endoscopy

CLINICAL PROFILE ASSOCIATED WITH BLEEDING BOWEL TUMORS IN PATIENTS UNDERGOING CAPSULE ENDOSCOPY (Abstract): Since the development and implementation into clinical practice of the small bowel (SB) capsule endoscopy (CE), obscure gastrointestinal bleeding (OGIB) is no longer an answerless question. In many cases of SB pathology, a definite diagnosis is made by SBCE, while other cases, as SB tumors (SBT), require additional investigations. Our aim was to identify predictors for SBT as OGIB etiology. Material and methods: We retrospectively studied all patients with OGIB who underwent SBCE in a two-year period. Only patients with positive findings were included. Patients with SBTs were compared to patients with non-tumoral cause of OGIB, and analyses for possible associated clinical factors were performed. Results: 205 SBCE exami-nations were performed for OGIB. Positive findings were noted in 134 patients (male gender: 72, female gender: 62; age range 21-79): 25 cases of SBTs, and 109 cases with non-tumoral causes responsible for bleeding (angioectasia, Crohn’s disease, NSAIDs enteritis, and other). SBT patients underwent further investigations, for confirmation and stadializa-tion. Patient’s age < 65 years, lack of anticoagulant treatment, and overt type of bleeding significantly associated with SBTs. Gender was not predictor for SBT. Surgery was the main therapeutic option for SBTs, significantly more frequently compared to the non-tumoral causes. Conclusion: Young age, overt bleeding and lack of anticoagulant treatment are factors associated with the final diagnosis of SBT. Because SBCE is only a visual technique and additional investigations are needed, predictors could anticipate the need for additional explorations and could help optimizing the investigational plan in terms of time and re-sources.