Small bowel endoscopy in familial adenomatous polyposis and Lynch syndrome

Jan Jacob Koornstra*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

37 Citations (Scopus)

Abstract

Patients with familial adenomatous polyposis (FAP) and patients with Lynch syndrome have an increased risk of developing small intestinal neoplasia. In both conditions, the lifetime risk to develop small bowel cancer is estimated to be around 5%. In FAP, this risk is associated with the degree of duodenal polyposis, classically assessed by the Spigelman classification. For this reason, gastroduodenal surveillance with forward-viewing and side-viewing endoscopy is generally recommended. Studies using video capsule endoscopy and balloon-assisted enteroscopy in FAP patients have revealed that jejunal and ileal polyps occur frequently in FAP, especially in those with extensive duodenal polyposis. Nevertheless, the clinical relevance of small bowel polyps beyond the duodenum appears to be limited. Compared to FAP, little is known about the prevalence and natural history of small bowel neoplasia in Lynch syndrome. Surveillance of the small bowel is not recommended in Lynch syndrome, although recent data using capsule endoscopy provided promising results. (C) 2012 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)359-368
Number of pages10
JournalBest practice & research in clinical gastroenterology
Volume26
Issue number3
DOIs
Publication statusPublished - Jun-2012

Keywords

  • FAP
  • Lynch syndrome
  • Duodenum
  • Small bowel
  • Capsule endoscopy
  • Surveillance
  • NONPOLYPOSIS COLORECTAL-CANCER
  • DOUBLE-BALLOON ENTEROSCOPY
  • WIRELESS CAPSULE ENDOSCOPY
  • DUODENAL ADENOMATOSIS
  • PROGNOSTIC-FACTORS
  • SMALL-INTESTINE
  • CLINICAL MANAGEMENT
  • PULL ENTEROSCOPY
  • ILEAL POUCH
  • SURVEILLANCE

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