Prospective enteroscopic evaluation of jejunal polyposis in patients with familial adenomatous polyposis and advanced duodenal polyposis
Duodenal cancer originating from duodenal adenomas is an important cause of death in patients with familial adenomatous polyposis (FAP). Small intestinal adenomas also occur distal to the duodenum, and literature suggests that they mainly occur in the proximal jejunum in patients with severe duodena...
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| Veröffentlicht in: | Familial cancer 2013-03, Vol.12 (1), p.51-56 |
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| creator | Alderlieste, Y. A. Rauws, E. A. J. Mathus-Vliegen, E. M. H. Fockens, P. Dekker, E. |
| description | Duodenal cancer originating from duodenal adenomas is an important cause of death in patients with familial adenomatous polyposis (FAP). Small intestinal adenomas also occur distal to the duodenum, and literature suggests that they mainly occur in the proximal jejunum in patients with severe duodenal polyp burden. We recently reported on 3 FAP-patients with a jejunal adenocarcinoma, all also harbouring advanced duodenal polyposis. Therefore we questioned whether FAP patients should also be submitted to endoscopic surveillance of the jejunum. The aim of this study was to determine the incidence and burden of jejunal adenomas in patients with FAP and advanced duodenal disease. All patients with FAP and advanced duodenal polyposis (Spigelman stage IV) at our academic centre were invited to undergo antegrade single balloon enteroscopy (Olympus SIF-Q180) with propofol-sedation. Patient characteristics, procedural characteristics (success, depth of insertion) and enteroscopic findings (number, size and pathology) are described. We identified 18 patients with FAP and duodenal polyposis Spigelman stage IV. Thirteen participated in the study with a mean age of 54 (30–64) years. SBE was successfully performed in 10 patients, with a mean depth of insertion of 72 cm beyond the ligament of Treitz. Adenomatous polyps were detected in 9 patients. Only one of them had extensive polyposis beyond Treitz, with large polyps covering up to one-third of the jejunal circumference. No cancers or adenomas with high-grade dysplasia were detected. Clinically significant jejunal polyposis in FAP is rare, even in high-risk patients with advanced duodenal disease. Routine jejunoscopy does not seem warranted in patients with FAP. |
| doi_str_mv | 10.1007/s10689-012-9571-1 |
| format | Article |
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A. ; Rauws, E. A. J. ; Mathus-Vliegen, E. M. H. ; Fockens, P. ; Dekker, E.</creator><creatorcontrib>Alderlieste, Y. A. ; Rauws, E. A. J. ; Mathus-Vliegen, E. M. H. ; Fockens, P. ; Dekker, E.</creatorcontrib><description>Duodenal cancer originating from duodenal adenomas is an important cause of death in patients with familial adenomatous polyposis (FAP). Small intestinal adenomas also occur distal to the duodenum, and literature suggests that they mainly occur in the proximal jejunum in patients with severe duodenal polyp burden. We recently reported on 3 FAP-patients with a jejunal adenocarcinoma, all also harbouring advanced duodenal polyposis. Therefore we questioned whether FAP patients should also be submitted to endoscopic surveillance of the jejunum. The aim of this study was to determine the incidence and burden of jejunal adenomas in patients with FAP and advanced duodenal disease. All patients with FAP and advanced duodenal polyposis (Spigelman stage IV) at our academic centre were invited to undergo antegrade single balloon enteroscopy (Olympus SIF-Q180) with propofol-sedation. Patient characteristics, procedural characteristics (success, depth of insertion) and enteroscopic findings (number, size and pathology) are described. We identified 18 patients with FAP and duodenal polyposis Spigelman stage IV. Thirteen participated in the study with a mean age of 54 (30–64) years. SBE was successfully performed in 10 patients, with a mean depth of insertion of 72 cm beyond the ligament of Treitz. Adenomatous polyps were detected in 9 patients. Only one of them had extensive polyposis beyond Treitz, with large polyps covering up to one-third of the jejunal circumference. No cancers or adenomas with high-grade dysplasia were detected. Clinically significant jejunal polyposis in FAP is rare, even in high-risk patients with advanced duodenal disease. Routine jejunoscopy does not seem warranted in patients with FAP.</description><identifier>ISSN: 1389-9600</identifier><identifier>EISSN: 1573-7292</identifier><identifier>DOI: 10.1007/s10689-012-9571-1</identifier><identifier>PMID: 23054214</identifier><identifier>CODEN: FCAAAJ</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adenoma - epidemiology ; Adenoma - pathology ; Adenomatous Polyposis Coli - pathology ; Adult ; Biomedical and Life Sciences ; Biomedicine ; Cancer Research ; Colorectal Neoplasms - complications ; Colorectal Neoplasms - pathology ; Duodenal Neoplasms - pathology ; Duodenum - pathology ; Endoscopy, Gastrointestinal ; Epidemiology ; Female ; Human Genetics ; Humans ; Incidence ; Jejunal Neoplasms - epidemiology ; Jejunal Neoplasms - pathology ; Jejunum - pathology ; Male ; Middle Aged ; Original Article ; Prospective Studies ; Risk Factors</subject><ispartof>Familial cancer, 2013-03, Vol.12 (1), p.51-56</ispartof><rights>Springer Science+Business Media Dordrecht 2012</rights><rights>Springer Science+Business Media Dordrecht 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-92769db9306321621d50450e5da4e7e4c3f45ee398b2f725a4eaed9c325526e23</citedby><cites>FETCH-LOGICAL-c372t-92769db9306321621d50450e5da4e7e4c3f45ee398b2f725a4eaed9c325526e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10689-012-9571-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10689-012-9571-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23054214$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alderlieste, Y. A.</creatorcontrib><creatorcontrib>Rauws, E. A. J.</creatorcontrib><creatorcontrib>Mathus-Vliegen, E. M. H.</creatorcontrib><creatorcontrib>Fockens, P.</creatorcontrib><creatorcontrib>Dekker, E.</creatorcontrib><title>Prospective enteroscopic evaluation of jejunal polyposis in patients with familial adenomatous polyposis and advanced duodenal polyposis</title><title>Familial cancer</title><addtitle>Familial Cancer</addtitle><addtitle>Fam Cancer</addtitle><description>Duodenal cancer originating from duodenal adenomas is an important cause of death in patients with familial adenomatous polyposis (FAP). Small intestinal adenomas also occur distal to the duodenum, and literature suggests that they mainly occur in the proximal jejunum in patients with severe duodenal polyp burden. We recently reported on 3 FAP-patients with a jejunal adenocarcinoma, all also harbouring advanced duodenal polyposis. Therefore we questioned whether FAP patients should also be submitted to endoscopic surveillance of the jejunum. The aim of this study was to determine the incidence and burden of jejunal adenomas in patients with FAP and advanced duodenal disease. All patients with FAP and advanced duodenal polyposis (Spigelman stage IV) at our academic centre were invited to undergo antegrade single balloon enteroscopy (Olympus SIF-Q180) with propofol-sedation. Patient characteristics, procedural characteristics (success, depth of insertion) and enteroscopic findings (number, size and pathology) are described. We identified 18 patients with FAP and duodenal polyposis Spigelman stage IV. Thirteen participated in the study with a mean age of 54 (30–64) years. SBE was successfully performed in 10 patients, with a mean depth of insertion of 72 cm beyond the ligament of Treitz. Adenomatous polyps were detected in 9 patients. Only one of them had extensive polyposis beyond Treitz, with large polyps covering up to one-third of the jejunal circumference. No cancers or adenomas with high-grade dysplasia were detected. Clinically significant jejunal polyposis in FAP is rare, even in high-risk patients with advanced duodenal disease. Routine jejunoscopy does not seem warranted in patients with FAP.</description><subject>Adenoma - epidemiology</subject><subject>Adenoma - pathology</subject><subject>Adenomatous Polyposis Coli - pathology</subject><subject>Adult</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cancer Research</subject><subject>Colorectal Neoplasms - complications</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Duodenal Neoplasms - pathology</subject><subject>Duodenum - pathology</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Incidence</subject><subject>Jejunal Neoplasms - epidemiology</subject><subject>Jejunal Neoplasms - pathology</subject><subject>Jejunum - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><issn>1389-9600</issn><issn>1573-7292</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kUtv1DAUhS0Eoi9-ABtkiQ2bUPvaTsZLVPGSKtEFXVse-wY8SuwQJ1P1H_CzuWUKGiGx8uN85_jKh7GXUryVQnSXVYp2YxshobGmk418wk6l6VTTgYWntFek2laIE3ZW604IEKC65-wElDAapD5lP2_mUicMS9ojx7wgHUOZUuC498Pql1QyLz3f4W7NfuBTGe6nUlPlKfOJZPJUfpeW77z3YxoSMT5iLqNfylqPeJ8jKXufA0Ye10LQcd4Fe9b7oeKLx_Wc3X54__XqU3P95ePnq3fXTVAdLI2FrrVxa5VoFcgWZDRCG4Emeo0d6qB6bRCV3Wyh78DQrcdogwJjoEVQ5-zNIXeay48V6-LGVAMOg89IAzsJGw1WSKkJff0PuivrTFP_ppQBsHpDlDxQgb6uzti7aU6jn--dFO6hJneoyVFN7qEmJ8nz6jF53Y4Y_zr-9EIAHIBKUv6G89HT_039BahioBg</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Alderlieste, Y. 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A.</au><au>Rauws, E. A. J.</au><au>Mathus-Vliegen, E. M. H.</au><au>Fockens, P.</au><au>Dekker, E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective enteroscopic evaluation of jejunal polyposis in patients with familial adenomatous polyposis and advanced duodenal polyposis</atitle><jtitle>Familial cancer</jtitle><stitle>Familial Cancer</stitle><addtitle>Fam Cancer</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>12</volume><issue>1</issue><spage>51</spage><epage>56</epage><pages>51-56</pages><issn>1389-9600</issn><eissn>1573-7292</eissn><coden>FCAAAJ</coden><abstract>Duodenal cancer originating from duodenal adenomas is an important cause of death in patients with familial adenomatous polyposis (FAP). Small intestinal adenomas also occur distal to the duodenum, and literature suggests that they mainly occur in the proximal jejunum in patients with severe duodenal polyp burden. We recently reported on 3 FAP-patients with a jejunal adenocarcinoma, all also harbouring advanced duodenal polyposis. Therefore we questioned whether FAP patients should also be submitted to endoscopic surveillance of the jejunum. The aim of this study was to determine the incidence and burden of jejunal adenomas in patients with FAP and advanced duodenal disease. All patients with FAP and advanced duodenal polyposis (Spigelman stage IV) at our academic centre were invited to undergo antegrade single balloon enteroscopy (Olympus SIF-Q180) with propofol-sedation. Patient characteristics, procedural characteristics (success, depth of insertion) and enteroscopic findings (number, size and pathology) are described. We identified 18 patients with FAP and duodenal polyposis Spigelman stage IV. Thirteen participated in the study with a mean age of 54 (30–64) years. SBE was successfully performed in 10 patients, with a mean depth of insertion of 72 cm beyond the ligament of Treitz. Adenomatous polyps were detected in 9 patients. Only one of them had extensive polyposis beyond Treitz, with large polyps covering up to one-third of the jejunal circumference. No cancers or adenomas with high-grade dysplasia were detected. Clinically significant jejunal polyposis in FAP is rare, even in high-risk patients with advanced duodenal disease. Routine jejunoscopy does not seem warranted in patients with FAP.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>23054214</pmid><doi>10.1007/s10689-012-9571-1</doi><tpages>6</tpages></addata></record> |
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| subjects | Adenoma - epidemiology Adenoma - pathology Adenomatous Polyposis Coli - pathology Adult Biomedical and Life Sciences Biomedicine Cancer Research Colorectal Neoplasms - complications Colorectal Neoplasms - pathology Duodenal Neoplasms - pathology Duodenum - pathology Endoscopy, Gastrointestinal Epidemiology Female Human Genetics Humans Incidence Jejunal Neoplasms - epidemiology Jejunal Neoplasms - pathology Jejunum - pathology Male Middle Aged Original Article Prospective Studies Risk Factors |
| title | Prospective enteroscopic evaluation of jejunal polyposis in patients with familial adenomatous polyposis and advanced duodenal polyposis |
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