Clinical Endoscopy

Endoscopic assessment of terminal ileum in screening colonoscopy: is it worth the effort?: Krzysztof Dąbkowski, Maciej Tryba, Ernest Biesiada, Kamila Konczanin, Małgorzata Michalak, Magdalena Szczygłowska, Krzysztof Safranow, Teresa Starzyńska; Clin Endosc 2025;58(5):731-737. Published online July 17, 2025; DOI: https://doi.org/10.5946/ce.2025.018

Background
/Aims: Screening colonoscopies often do not include terminal ileum assessment. In this study, we examined how often endoscopists assessed the terminal ileum during screening colonoscopy, how it influenced the procedure time and patient comfort, and whether it revealed pathological findings.
Methods
We retrospectively analyzed the screening colonoscopy examinations performed in our department between 2017 and 2021. We retrieved the procedure duration (minutes), patient age and sex, pain scale, and screening colonoscopy results.
Results
A total of 2,449 screening colonoscopy examinations were performed between 2017 and 2021. The patients were classified into one of two groups: the cecum reached or the terminal ileum intubated. These two groups did not significantly differ in sex or reported pain score, while the patients were significantly younger (55.2±6.5 vs. 56.2±6 years, p=0.015) and the colonoscopy duration was longer (22.8±9.8 vs. 18±10.5 min, p<0.001) in the terminal ileum group. Pathological conditions (nonspecific inflammatory lesions) in the small intestine were reported in 5/297 patients.
Conclusions
Small intestine intubation was associated with a significantly longer colonoscopy duration and revealed pathological conditions of no apparent clinical significance.

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Endoscopic assessment of terminal ileum in screening colonoscopy: insights from a retrospective analysis
Motij Kumar Dalai, Yogesh Bairwa, Rohit Wagh, Sanjay Jagdish Chandnani
Clinical Endoscopy.2026; 59(2): 323. CrossRef
Terminal ileum in screening colonoscopy: routine practice or risk-stratified approach?
Seong-Jung Kim
Clinical Endoscopy.2025; 58(5): 696. CrossRef

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The Role of Endoscopy in Small Bowel Neuroendocrine Tumors: Ji Yoon Yoon, Nikhil A. Kumta, Michelle Kang Kim; Clin Endosc 2021;54(6):818-824. Published online April 1, 2021; DOI: https://doi.org/10.5946/ce.2020.296

Abstract PDF

Small bowel neuroendocrine tumors (NETs) represent approximately one-third of NETs of the gastrointestinal tract, and their incidence is increasing. When determining if endoscopic resection is appropriate, endoscopic ultrasound is used to assess the lesion size and depth of invasion for duodenal NETs. A number of techniques, including endoscopic mucosal resection (EMR), band-assisted EMR (band-EMR), endoscopic submucosal dissection (ESD), and over-the-scope clip-assisted endoscopic full-thickness resection (EFTR), have been studied; however, the best technique for endoscopic resection remains unclear. The vast majority of currently available data are retrospective, and prospective studies with longer follow-up times are required. For jejunal and ileal NETs, endoscopic techniques such as video capsule endoscopy (VCE) and balloon enteroscopy (BE) assist in diagnosis. This includes localization of the primary NET in metastatic disease where initial workup has been negative, and the identification of multifocal disease, which may change management and prognostication.

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Gastroenteropancreatic Neuroendocrine Tumors
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Mohamed S. EL Shahawy
Annals of Medicine & Surgery.2026; 88(2): 1881. CrossRef
Comparison of endoscopic mucosal resection combined with band ligation versus endoscopic submucosal dissection for small rectal neuroendocrine tumors (≤ 10 mm): a systematic review and meta-analysis
Yan Deng, Ting Zhang, Lidan Yang, Wenquan Yi
BMC Gastroenterology.2026;[Epub] CrossRef
The Sunburst Sign in the Mesentery: Unveiling the Diagnosis With ⁶⁸Ga DOTATATE PET/CT
Ömer F. Şahin, Dilruba Şahin, Zehranur Tosunoğlu
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Faure Rodriguez Velasquez, Andres Montoya, Daniela Riaño-Pineda, Gabriela Urdinola, Alejandra Sogamoso-Bohórquez, Juan Galves-Cetina, Eduardo Tuta-Quintero
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Ileal neuroendocrine tumors: clinicopathological features and associations with systemic inflammatory and nutritional markers
Nicolae Dragoş Mărgăritescu, Tiberiu Ştefăniţă Ţenea-Cojan , Gabriel Florin Răzvan Mogoş , Stelian Ştefăniţă Mogoantă , Liviu Vasile, Liliana Cercelaru, Laurenţiu Augustus Barbu
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Long-Term Outcomes in Patients With Non-Ampullary Duodenal Neuroendocrine Tumors
Da-Bin Jeong, Sang-Gyun Kim, Soo-Jeong Cho
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(1): 54. CrossRef
Endoscopic diagnosis and treatment of duodenal neuroendocrine tumours: the experience of the P.A. Hertsen Moscow Oncology Research Institute
V. I. Ryabtseva, S. S. Pirogov, I. B. Perfiliev, D. G. Sukhin, M. A. Paronian, G. F. Minibaeva, N. S. Goeva, N. N. Volchenko
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Small Bowel Neuroendocrine Neoplasms—A Review
Sai Swarupa Vulasala, Mayur Virarkar, Dheeraj Gopireddy, Rebecca Waters, Ahmad Alkhasawneh, Ziad Awad, Jessica Maxwell, Nisha Ramani, Sindhu Kumar, Nirmal Onteddu, Ajaykumar C. Morani
Journal of Computer Assisted Tomography.2024; 48(4): 563. CrossRef
Performance of capsule endoscopy for the detection of small intestinal neuroendocrine tumors in familial carcinoid: a prospective single-site study
Derek Tang, Ramona Lim, Louis Korman, Joanne Forbes, Kristen Ellsbury, Sungyoung Auh, Apurva Trivedi, Clara C. Chen, Marybeth Hughes, Stephen Wank
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Multimodal management of foregut neuroendocrine neoplasms
Yichan Zhou, James Weiquan Li, Noriya Uedo
Best Practice & Research Clinical Gastroenterology.2024; 68: 101889. CrossRef
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Sara Massironi, Marianna Franchina, Davide Ippolito, Federica Elisei, Olga Falco, Cesare Maino, Fabio Pagni, Alessandra Elvevi, Luca Guerra, Pietro Invernizzi
Expert Review of Endocrinology & Metabolism.2024; 19(4): 349. CrossRef
Quantitative characterization of duodenal gastrinoma autofluorescence using multiphoton microscopy
Thomas G. Knapp, Suzann Duan, Juanita L. Merchant, Travis W. Sawyer
Lasers in Surgery and Medicine.2023; 55(2): 208. CrossRef
Ileal Neuroendocrine Tumors Detected During Screening or Diagnostic Colonoscopy — Case Series and Comparison of Tumor Characteristics
Kaden R. Narayani, Raj I. Narayani
Journal of Gastrointestinal Cancer.2023; 54(4): 1374. CrossRef
Imaging of Small-Bowel Neuroendocrine Neoplasms: AJR Expert Panel Narrative Review
Patrick J. Navin, Eric C. Ehman, Jason B. Liu, Thorvardur R. Halfdanarson, Akshya Gupta, Andrea Laghi, Don C. Yoo, Laura R. Carucci, Wolfgang Schima, Shannon P. Sheedy
American Journal of Roentgenology.2023; 221(3): 289. CrossRef
Magnifying Endoscopy with Narrow-Band Imaging for Duodenal Neuroendocrine Tumors
Gwang Ha Kim, Kiyoun Yi, Dong Chan Joo, Moon Won Lee, Hye Kyung Jeon, Bong Eun Lee
Journal of Clinical Medicine.2023; 12(9): 3106. CrossRef
Long-term outcomes of endoscopic resection for duodenal neuroendocrine tumors
Kiyoun Yi, Gwang Ha Kim, Su Jin Kim, Cheol Woong Choi, Moon Won Lee, Bong Eun Lee, Geun Am Song
Scientific Reports.2023;[Epub] CrossRef
Endoscopic full-thickness resection of well-differentiated T2 neuroendocrine tumors in the duodenal bulb: a case series
Sarah Dwyer, Shaffer Mok
VideoGIE.2022; 7(5): 196. CrossRef
State of the Art in Endoscopic Therapy for the Management of Gastroenteropancreatic Neuroendocrine Tumors
Apostolis Papaefthymiou, Faidon-Marios Laskaratos, Apostolos Koffas, Anastasios Manolakis, Paraskevas Gkolfakis, Sergio Coda, Mikael Sodergren, Noriko Suzuki, Christos Toumpanakis
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The utility of near infrared autofluorescence imaging for detecting small bowel carcinoid tumors in comparison to DOTATATE PET: A pilot study
Eren Berber, Onuralp Ergun, Seyma Avci, Gizem Isiktas, Mohammed Osman, Paresh Mahajan
Journal of Surgical Oncology.2022; 126(7): 1199. CrossRef
Gastroenteropancreatic Neuroendocrine Tumors
Conrad J. Fernandes, Galen Leung, Jennifer R. Eads, Bryson W. Katona
Gastroenterology Clinics of North America.2022; 51(3): 625. CrossRef

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Clinicopathological Features of Small Bowel Tumors Diagnosed by Video Capsule Endoscopy and Balloon-Assisted Enteroscopy: A Single Center Experience: Ah Young Yoo, Beom Jae Lee, Won Shik Kim, Seong Min Kim, Seung Han Kim, Moon Kyung Joo, Hyo Jung Kim, Jong-Jae Park; Clin Endosc 2021;54(1):85-91. Published online August 31, 2020; DOI: https://doi.org/10.5946/ce.2020.047

Abstract PDF

Background
/Aims: Small bowel malignancies often present a diagnostic challenge due to their relative rarity and nonspecific clinical symptoms. However, technical developments in endoscopic instruments, including video capsule endoscopy (VCE) and enteroscopy, have allowed for the visualization of the entire small bowel. This study aimed to investigate the clinicopathological features of small bowel malignant tumors diagnosed by VCE and double-balloon enteroscopy (DBE) in a single tertiary center.
Methods
We retrospectively analyzed VCE and DBE findings from Korea University Guro Hospital from January 2010 through September 2018.
Results
A total of 510 VCE and 126 DBE examinations were performed in 438 patients. Small bowel malignancies were diagnosed in 28 patients (15 males; mean age, 61.0 years; range, 42 to 81 years). Among them, 8 had lymphoma, 8 had primary adenocarcinoma, 7 had gastrointestinal stromal tumor (GIST) and 5 had metastatic cancer. Abdominal pain and obstructive symptoms were the most common findings in metastatic cancers (4/5, 80%). On the other hand, obscure gastrointestinal bleeding was the most common symptom of GIST (6/7, 85.7%) and adenocarcinoma (3/8, 37.5%).
Conclusions
Approximately 6% of the patients who underwent either VCE or DBE were diagnosed with small bowel malignancy. These findings demonstrated the different clinical characteristics among small bowel malignancies and merit further study.

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Clinicopathological Profiles and Outcomes of Small Bowel Tumors: A 15-Year Experience at a Tertiary Care Center in South India
Sharath K Krishnan, Ravindran Chirukandath, Sumin V Sulaiman, Arun Zacharia Thomas
Cureus.2026;[Epub] CrossRef
Balloon-assisted enteroscopy in the management of adult small-bowel intussusception: a comparative analysis of with and without double-balloon enteroscopy
Won Shik Kim, Beom Jae Lee, Moon Kyung Joo, Seung Han Kim, Jong-Jae Park
Surgical Endoscopy.2025; 39(3): 2044. CrossRef
Small Bowel Tumors: A 7-Year Study in a Tertiary Care Hospital
Sergiu Marian Cazacu, Dan Cârțu, Mihai Popescu, Liliana Streba, Bogdan Silviu Ungureanu, Vlad Florin Iovănescu, Mihai Cimpoeru, Cecil Sorin Mirea, Valeriu Marian Surlin, Stelian Mogoantă, Mirela Marinela Florescu
Cancers.2025; 17(9): 1465. CrossRef
Prognostic factors for liver metastasis in patients with small intestinal stromal tumor: A retrospective analysis of surveillance, epidemiology, and end results
Luojie Liu, Rufa Zhang, Zhenguo Qiao, Ye Ye, Kaijian Xia, Yunfu Feng, Xiaodan Xu
World Journal of Surgery.2024; 48(3): 598. CrossRef
Primitive Resectable Small Bowel Cancer Clinical–Pathological Analysis: A 10-Year Retrospective Study in a General Surgery Unit
Cosmin Vasile Obleagă, Costin Teodor Streba, Cecil Sorin Mirea, Ionică Daniel Vîlcea, Dan Nicolae Florescu, Mihai Călin Ciorbagiu, Tudor Turcu, Mirela Marinela Florescu, Mircea Sebastian Șerbănescu, Alina-Maria Mehedințeanu, Cristin Constantin Vere
Cancers.2024; 16(21): 3713. CrossRef
A practical approach for small bowel bleeding
Sung Eun Kim, Hyun Jin Kim, Myeongseok Koh, Min Cheol Kim, Joon Sung Kim, Ji Hyung Nam, Young Kwan Cho, A Reum Choe
Clinical Endoscopy.2023; 56(3): 283. CrossRef
Clinicopathological characteristics and prognostic factors of small bowel lymphomas: a retrospective single-center study
Emanuel Dias, Renato Medas, Margarida Marques, Patrícia Andrade, Hélder Cardoso, Guilherme Macedo
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Small Bowel Capsule Endoscopy and Enteroscopy: A Shoulder-to-Shoulder Race
Ana-Maria Singeap, Catalin Sfarti, Horia Minea, Stefan Chiriac, Tudor Cuciureanu, Robert Nastasa, Carol Stanciu, Anca Trifan
Journal of Clinical Medicine.2023; 12(23): 7328. CrossRef
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Priya Oka, Reena Sidhu
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Indication, Location of the Lesion, Diagnostic Yield, and Therapeutic Yield of Double-Balloon Enteroscopy: Seventeen Years of Experience
Sang Pyo Lee, Hyun Joo Jang, Sea Hyub Kae, Jae Gon Lee, Ji Hye Kwon
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Sung Chul Lee
International Journal of Surgery Case Reports.2021; 79: 354. CrossRef
Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
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Lessons from Korean Capsule Endoscopy Multicenter Studies: Kyeong Ok Kim, Byung Ik Jang; Clin Endosc 2012;45(3):290-294. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.290

Abstract PDF

Since its development, video capsule endoscopy (VCE) introduced a new area in the study of small bowel disease. We reviewed and discussed current issues from Korean capsule endoscopy multicenter studies. Main results are as follows: First, there was no significant difference in diagnostic yield according to the method of bowel preparation. Second, VCE represents a reliable and influential screening measure in patients with chronic unexplained abdominal pain and this technique could successfully alter the clinical course especially for patients with small bowel tumor. Third, the inter-observer variation in the expert group was lower than that in trainee group. Fourth, studies about the spontaneous capsule passage after retention showed 2.5% of retention rate and the size of lumen was an important factor of spontaneous passage. We need larger scale studies on the effect of bowel preparation methods on the diagnostic yield and further studies about the learning curve or unique capsule endoscopic findings for small intestinal diseases in Korean patients.

Citations

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Factors Affecting Diagnostic Yields of Capsule Endoscopy for Obscure Gastrointestinal Bleeding
Na Rae Lim, Keep Yung Hong, Woo Chul Chung
Gastrointestinal Disorders.2024; 6(2): 468. CrossRef
Lack of benefit of active preparation compared with a clear fluid–only diet in small-bowel visualization for video capsule endoscopy: results of a randomized, blinded, controlled trial
Lawrence Hookey, Jacob Louw, Michelle Wiepjes, Natalie Rubinger, Stijn Van Weyenberg, Andrew G. Day, William Paterson
Gastrointestinal Endoscopy.2017; 85(1): 187. CrossRef
Retention associated with video capsule endoscopy: systematic review and meta-analysis
Mona Rezapour, Chidi Amadi, Lauren B. Gerson
Gastrointestinal Endoscopy.2017; 85(6): 1157. CrossRef
Small Bowel Endoscopy in Inflammatory Bowel Disease
Hirokazu Yamagami, Kenji Watanabe, Noriko Kamata, Mitsue Sogawa, Tetsuo Arakawa
Clinical Endoscopy.2013; 46(4): 321. CrossRef

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Role of Computed Tomography Enterography/Magnetic Resonance Enterography: Is It in Prime Time?: Ah Young Kim; Clin Endosc 2012;45(3):269-273. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.269

Abstract PDF

Today, cross-sectional imaging modalities, such as computed tomography enterography (CTE) and magnetic resonance enterography (MRE), are particularly suited to evaluate small bowel diseases, especially Crohn's disease (CD). It is well known that CTE/MRE can provide excellent assessment of disease activity as well as the macroscopic features, extramural abnormalities, and complications of the small intestine in patients with CD. In general, CTE is considered as the first-line modality for the evaluation of suspected inflammatory bowel disease and for long-term assessment or follow-up of these patients. Because of the advantage of lack of radiation, MRE is being used more frequently, especially in children or young patients with CD.

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Patient radiation safety in imaging in Crohn’s disease
Sahil S Shet, Ronan James Lee, Eid Kakish, Ludolf De Kock, David J Ryan, Michael M Maher
British Journal of Radiology.2026; 99(1177): 14. CrossRef
Indian guidelines on imaging of the small intestine in Crohn’s disease: A joint Indian Society of Gastroenterology and Indian Radiology and Imaging Association consensus statement
Saurabh Kedia, Raju Sharma, Govind Makharia, Vineet Ahuja, Devendra Desai, Devasenathipathy Kandasamy, Anu Eapen, Karthik Ganesan, Uday C Ghosha, Naveen Kalra, R Karthikeyan, Kumble Seetharama Madhusudhan, Mathew Philip, Amarender Puri, Sunil Puri, Saroj
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Pradeep Goyal, Jimil Shah, Sonali Gupta, Pankaj Gupta, Vishal Sharma
Expert Review of Gastroenterology & Hepatology.2019; 13(10): 995. CrossRef
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Didi Wen, Jian Xu, Ying Liu, Rui An, Jian Li, Hongliang Zhao, Minwen Zheng
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Ileal Crohn's disease activity predicted by ruler: CT enterography histopathology correlation
Tamer W. Kassem
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Faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease: a prospective study
Takahiro Shimoyama, Takayuki Yamamoto, Satoru Umegae, Koichi Matsumoto
Therapeutic Advances in Gastroenterology.2017; 10(8): 577. CrossRef
Imaging of the small intestine in Crohn’s disease: Joint position statement of the Indian Society of Gastroenterology and Indian Radiological and Imaging Association
Saurabh Kedia, Raju Sharma, Govind K. Makharia, Vineet Ahuja, Devendra Desai, Devasenathipathy Kandasamy, Anu Eapen, Karthik Ganesan, Uday C. Ghoshal, Naveen Kalra, D. Karthikeyan, Kumble Seetharama Madhusudhan, Mathew Philip, Amarender Singh Puri, Sunil
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Diagnosis of Small-Bowel Diseases: Prospective Comparison of Multi–Detector Row CT Enterography with MR Enterography
Gabriele Masselli, Marco Di Tola, Emanuele Casciani, Elisabetta Polettini, Francesca Laghi, Riccardo Monti, Maria Giulia Bernieri, Gianfranco Gualdi
Radiology.2016; 279(2): 420. CrossRef
Value of Computerized Tomography Enterography in Predicting Crohn’s Disease Activity: Correlation with Crohn’s Disease Activity Index and C-Reactive Protein
Eun Kyung Park, Na Yeon Han, Beom Jin Park, Deuk Jae Sung, Sung Beom Cho, Yoon Tae Jeen, Bora Keum, Min Ju Kim
Iranian Journal of Radiology.2016;[Epub] CrossRef
Identifying the inflammatory and fibrotic bowel stricture: MRI diffusion-weighted imaging in Crohn's disease
Jianguo Zhu, Faming Zhang, Fei Liu, Wenwen He, Jun Tian, Huiyun Han, Peng Cao
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Imaging Inflammatory Bowel Disease with CT and MR Enterography
Piotr Starakiewicz, David J. Grand
Current Radiology Reports.2013; 1(4): 277. CrossRef

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A Case of Transient Small Intestinal Intussusceptions in an Adult: Yeong Geol Jo, M.D., Tae Hee Lee, M.D., Soon Hyo Kwon, M.D., Gang Il Cheon, M.D., Hyun Gun Kim, M.D., Wan Jung Kim, M.D., Jin Oh Kim, M.D. and Joon Seong Lee, M.D.; Korean J Gastrointest Endosc 2011;42(5):315-319. Published online May 28, 2011

Abstract PDF: Intussusception occurs when a segment of the bowel invaginates into the lumen of an adjacent distal segment. Intussusception in adults is a rare disease, accounting for only 5% of all cases. Asymptomatic small bowel intussusception in adults without a lead point is usually transient. When the length of the intussusception is less than 3.5 cm, it can be managed conservatively. This case was an asymptomatic small bowel intussusception without a lead point, which was discovered incidentally during an abdominal computed tomography scan. Spontaneous reduction in the intussusception was observed without any complications while maintaining conservative treatment only. (Korean J Gastrointest Endosc 2011; 42:315-319)

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Indications for Enteroscopy: Which Patients Should Be Recommended for Enteroscopy?: Hwang Choi, M.D.; Korean J Gastrointest Endosc 2011;42(3):137-142. Published online March 28, 2011

Abstract PDF: Balloon-assisted endoscopy (double-balloon or single-balloon endoscopy) is a novel method used to examine the entire small bowel. Enteroscopy has advantages in that tissues can be obtained to get a detailed image, and it is feasible for endoscopic treatments such as hemostasis, dilatation, and polypectomy. Indications for enteroscopy are obscure gastrointestinal bleeding, small bowel involvement due to inflammatory bowel disease, an investigation of a small bowel tumor or polyposis, and difficulty of a colonoscopy. Enteroscopy should be recommended to patients with recurrent mid-gut bleeding of obscure origin, suspected Crohn's disease, suspicious small bowel tumor on abnormal imaging, and surveillance of polyposis syndrome including familial adenomatous polyposis and Peutz-Jeghers syndrome. We may consider enteroscopy in patients with chronic abdominal pain or diarrhea and increased inflammatory markers. We must also understand the contraindications, complications, and limitations of enteroscopy. (Korean J Gastrointest Endosc 2011;42:137-142)

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Endoscopic Polypectomy of Small Intestinal Peutz-Jeghers Polyps with Double Balloon Enteroscopy: Mi-Young Kim, M.D., Jeong-Sik Byeon, M.D., Kee Don Choi, M.D., Byong Duk Ye, M.D., Dong-Hoon Yang, M.D., Soon Man Yoon, M.D., Kyung-Jo Kim, M.D., Seung-Jae Myung, M.D., Suk-Kyun Yang, M.D. and Jin-Ho Kim, M.D.; Korean J Gastrointest Endosc 2009;39(6):338-345. Published online December 30, 2009

Abstract PDF: Background
/Aims: Small intestinal polyps in patients with Peutz-Jeghers (PJ) syndrome cause therapeutic difficulties because of the necessity for repeated laparotomy. We evaluated the short-term outcomes and long-term usefulness of double balloon enteroscopy (DBE) polypectomy for treating small intestinal PJ polyps.
Methods
We retrospectively reviewed 10 patients with PJ syndrome (M：F=7：3, mean age 22.7 years) and whose small intestinal polyps were resected with DBE between January 2005 and July 2008. We analyzed their clinical, endoscopic and pathologic features, the short-term outcomes and the long-term follow-up results.
Results
Among 10 patients, 2 complained hematochezia and 2 presented with intussusceptions. DBE polypectomy was performed by the oral route in 4 patients, by the anal route in 1 and by both routes in 5 without significant complications, except for only one perforation. The polyps were 0.5∼6 cm in size and most of them were pedunculated. The histopathology revealed hamartomatous polyps in most cases. Follow-up small bowel series was performed in 6 of 10 patients, and 3 showed remnant polyps. Two of them underwent repeated DBE polypectomy without significant complications.
Conclusions
We suggest that DBE polypectomy is a useful treatment for PJ small intestinal polyps because of the good short-term outcome and the effectiveness of repeated polypectomy for the remnant or recurrent polyps. (Korean J Gastrointest Endosc 2009;39:338-345)

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Therapeutic Small Bowel Endoscopy in Practice: Hyun Joo Jang, M.D.; Korean J Gastrointest Endosc 2009;39(2):59-65. Published online August 30, 2009

Abstract PDF: Since the first introduction of double balloon enteroscopy (DBE) in 2001, DBE has been refined for complete exploration of the small bowel and therapeutic interventions. Diagnostic DBE using a model EN-450P5 (Fujinon, Saitama, Japan) equipped with a small accessory channel is mainly used for endoscopic observation and limited therapeutic procedures including injection therapy, argon plasma coagulation and polypectomy. Therapeutic DBE utilizing a model EN-450T5 (Fujinon, Saitama, Japan) equipped with a larger accessory channel was developed for various endoscopic interventions. Recently, new enteroscopic techniques such as single balloon enteroscopy and spiral enteroscopy were introduced. These enteroscopic techniques are all used for the controlled observation, targeted tissue sampling for pathologic evaluation and various therapeutic interventions. The overall complication rate of DBE seems acceptable but that of therapeutic DBE is higher than diagnostic DBE and therapeutic colonoscopies because the small intestinal wall is much thinner than other intestinal wall. This review provides an overview concerning therapeutic interventions of DBE. (Korean J Gastrointest Endosc 2009;39:59-65)

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Comparison of Double Balloon Enteroscopy and Capsule Endoscopy for Patients with Suspected Small Bowel Diseases: Hyun Joo Jang, M.D., Cheol Hee Park, M.D., Seung Yong Han, M.D., Hyun Woo Byun, M.D., Min Ho Choi, M.D., Sea Hyub Kae, M.D. and Jin Lee, M.D.; Korean J Gastrointest Endosc 2007;35(6):379-384. Published online December 30, 2007

Abstract PDF: Background
/Aims: Double balloon enteroscopy (DBE) and capsule endoscopy (CE) are two new methods for evaluating small bowel diseases. However, the clinical relevance of these procedures remains to be uncovered. We investigated the diagnostic and therapeutic impact of DBE and CE for patients with suspected small bowel diseases. Methods: We retrospectively reviewed the medical records of 60 patients who were examined by DBE or CE for suspected small bowel diseases between May 2003 and September 2005. The diagnostic yield and therapeutic impact were compared between the two groups. Results: Thirty-five patients were examined by CE and 25 patients were examined by DBE. DBE showed abnormal findings in 20 patients (80%). CE detected abnormal findings in 23 patients (65.7%). The overall diagnostic yield was not different between the two groups (p=0.226). In the DBE group, therapeutic interventions were performed in 18 patients (72%). In the CE group, therapeutic interventions were performed in 7 patients (20%). The overall therapeutic impact showed a significant difference between the two procedures (p<0.001). Conclusions: Although there is no significant difference in the diagnostic yield between the two procedures, DBE appears to have a higher therapeutic yield than CE for patients with suspected small bowel diseases. (Korean J Gastrointest Endosc 2007;35:379-384)

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The Usefulness of Capsule Endoscopy in Patients with Obscure Gastrointestinal Bleeding: Hyun Jeong Kim, M.D., Chan Sup Shim, M.D., Sang Ho Lee, M.D., In Seop Jung, M.D., Su Jin Hong, M.D., Chang Bum Ryu, M.D., Jin Oh Kim, M.D., Joo Young Cho, M.D., June Seong Lee, M.D., Moon Sung Lee, M.D. and Boo Sung Kim, M.D.; Korean J Gastrointest Endosc 2005;31(3):140-146. Published online September 30, 2005

Abstract PDF: Background
/Aims: Obscure gastrointestinal bleeding (OGIB) is defined as recurrent bleeding for which no source has been identified by routine endoscopic and contrast studies. This study was performed to determine the utility of capsule endoscopy in patients with OGIB. Methods: This retrospective study included 21 patients with GIB which were not identified by esophagogastroduodenoscopy and colonoscopy. Those were sixteen patients with overt OGIB (including 6 ongoing overt bleeding) and five with occult OGIB. All underwent capsule endoscopy with Given M2A video capsule system. Results: Definite bleeding of small intestine were identified in 9 of 21 patients (42.9%) and 8 of 9 patients presenting as overt OGIB (50.0%, 8/16). Additionally, 5 of 6 patients with ongoing bleeding on the day of capsule endoscopy were found to have the lesion in small intestine (83.3%, 5/6). Ulcers were found in 6 patients, diverticulitis in 2 patients, and a tumor in 1 patients. Conclusions: Capsule endoscopy, providing a good visualization of small intestine, is safe and well tolerated. Capsule endoscopy is an useful diagnostic tool for OGIB, especially for ongoing overt bleeding, and can guide the subsequent therapy and expand diagnostic yield in OGIB. (Korean J Gastrointest Endosc 2005;31:140⁣146)

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The Usefulness of Capsule Endoscopy in Patients with Obscure Gastrointestinal Bleeding: Hyun Jeong Kim, M.D., Chan Sup Shim, M.D., Sang Ho Lee, M.D., In Seop Jung, M.D., Su Jin Hong, M.D., Chang Bum Ryu, M.D., Jin Oh Kim, M.D., Joo Young Cho, M.D., June Seong Lee, M.D., Moon Sung Lee, M.D. and Boo Sung Kim, M.D.; Korean J Gastrointest Endosc 2005;31(3):140-146. Published online September 30, 2005

Abstract PDF: Background
/Aims: Obscure gastrointestinal bleeding (OGIB) is defined as recurrent bleeding for which no source has been identified by routine endoscopic and contrast studies. This study was performed to determine the utility of capsule endoscopy in patients with OGIB. Methods: This retrospective study included 21 patients with GIB which were not identified by esophagogastroduodenoscopy and colonoscopy. Those were sixteen patients with overt OGIB (including 6 ongoing overt bleeding) and five with occult OGIB. All underwent capsule endoscopy with Given M2A video capsule system. Results: Definite bleeding of small intestine were identified in 9 of 21 patients (42.9%) and 8 of 9 patients presenting as overt OGIB (50.0%, 8/16). Additionally, 5 of 6 patients with ongoing bleeding on the day of capsule endoscopy were found to have the lesion in small intestine (83.3%, 5/6). Ulcers were found in 6 patients, diverticulitis in 2 patients, and a tumor in 1 patients. Conclusions: Capsule endoscopy, providing a good visualization of small intestine, is safe and well tolerated. Capsule endoscopy is an useful diagnostic tool for OGIB, especially for ongoing overt bleeding, and can guide the subsequent therapy and expand diagnostic yield in OGIB. (Korean J Gastrointest Endosc 2005;31:140⁣146)

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A Case of Strangulated Intussusception Caused by the Small Intestinal Lipoma in Adult: Tae Hee Kim, M.D., Sung Yeun Yang, M.D., Soo Kyoung Kwon, M.D., Jeong Ha Pak, M.D., Kyung Im Bae, M.D., Sang Heon Lee, M.D., Sam Rong Jee, M.D., Eun Taek Pak, M.D., Sang Hyuk Lee, M.D., Sang Yong Seol, M.D., Jung Myung Chung, M.D., Woon Won Kim, M.D.*, Sa; Korean J Gastrointest Endosc 2004;29(3):156-159. Published online September 30, 2004

Abstract PDF: An intussusception in adulthood is an unusual cause of bowel obstruction. It accounts for up to 5% of all intussusception. Approximately 90% of cases are secondary to a definite lesion such as malignancy or lipoma. Most patients are asymptomatic and the lesion is often detected incidentally at colonoscopy, operation and autopsy. Strangulated intussuscetion is a rare case and also requires emergency operation. A 32-year-old woman visited our emergency room because of severe epigastric pain. Abdominal CT revealed a low density mass in bowel loop and distended small bowel loops filled with fluid. Colonoscopic finding showed huge purple-colored coil-spring lesion in the ascending colon. From this findings, we diagnosed a strangulated intussusception. Surgically removed specimen revealed a small intestinal lipoma. (Korean J Gastrointest Endosc 2004;29:156⁣159)

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Two Cases of Small Intestinal Nodular Lymphoid Hyperplasia: Sung Hun Moon, M.D., Sang Young Han, M.D. Chae Ryung Jang, M.D., Tae Yeong Lee, M.D.,; Korean J Gastrointest Endosc 2003;26(4):226-231. Published online April 30, 2003

Abstract PDF: Pseudolymphoma or lymphoid hyperplasia is a rare clinicopathologic disease which occurs in a variety of sites including the skin, orbit, salivary glands, gastrointestinal tract, lung, and other organs. Lymphoid hyperplasia of the gastrointestinal tract can be categorized into four clinicopathologic groups: focal lymphoid hyperplasia of the stomach, focal lymphoid hyperplasia of the small intestine, focal lymphoid hyperplasia of the rectum, and nodular lymphoid hyperplasia of the gastrointestinal tract. We experienced two cases of nodular lymphoid hyperplasia of the small intestine with hypogammaglobulinemia (IgA deficiency) and without hypogammaglobulinemia presented with epigastric discomfort. Esophagogastroduodenoscopy and small bowel series showed 0.2∼0.5 cm sized small, numerous Yamada-I or Yamada-II polypoid lesions from the duodenal bulb to the terminal ileum in two cases. Histologic finding of the duodenal bulb showed small round mature lymphocyte infiltration and reactive follicle with germinal center in two cases. We report two cases with a brief reviews of literature. (Korean J Gastrointest Endosc 2003; 26:226⁣231)

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증례 : 식도 위장관 ; 위 , 십이지장 , 공장에 발생한 MALToma 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of MALToma Involving Stomach and Small Intestine ): Korean J Gastrointest Endosc 1998;18(6):917-921. Published online November 30, 1997

Abstract PDF: A 74- year old male was admitted to St. Mary's Hospital due to symptoms of diarrhea and fever. He was diagnosed with MALToma in the jejunum 6 months previously, but had refused any treatment. This time, an endoscopy revealed multiple erosions and nodular mucosa in the body, fundus of the stomach and 3rd portion of duodenum. Abdominal computed tomography showed wall thickening in 3rd portion of the duodenum and upper jejunum with multiple lymph nodes enlargement. Additionally, an endoscopic biopsy revealed MALToma in the stomach and duodenum. Salmonella group B grew in a blood culture and a chest PA determined pneumonic infiltration in the left lower lobe. He received sulperazone for 7 days, but again refused any further treatment and was thereby discharged after had improved condition. (Korean J Gastrointest Endosc 18: 917-921, 1998)

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증례 : 장중첩증을 초발증세로 한 회장의 원발성 림프종 1예 ( Case Reports : Primary Malignant Lymphoma of the Small Intestine Causing Adult Intussusception as an Initial Symptom ): Korean J Gastrointest Endosc 1994;14(1):100-104. Published online November 30, 1993

Abstract PDF: While intussusception can occur at any age, the disease is most often seen in children and no etiologic factor can be seen in most cases of childhood intussusception. In contrast, the adult intussusception is rare and usually has an identifiable causes such as benign tumor, malignant tumor, sarcoma, Meckel's diverticulum and congenital anomaly. Especially, adult intussusception due to primary malignant lymphoma of small intestine is rare clinical condition. Here, we describe the case of a 49-year-old male patient with ileo-ileo-colic intussusception due to primary malignant lymphoma of the small intestine. The clinical, radiographic and pathologic findings are described with brief review of the literature.

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