Frequency of Small Bowel Polyps in Patients with Duodenal Adenoma But Without Familial Adenomatous Polyposis

Frequency of Small Bowel Polyps in Patients with Duodenal Adenoma But Without Familial Adenomatous Polyposis Dirk Hartmann, Phillip Erben, Dieter Schilling, Ulrich Damian, Juergen F. Riemann Background: Duodenal adenomas are extremly common in patients with familial adenomatous polyposis. However, it is uncertain wether patients with duodenal adenomas without familial adenomatous polyposis are at greater risk for small bowel neoplasia and, therefore should routinely undergo surveillance small bowel examination. The aim of this study was to determine whether there is a correlation between non-papillary duodenal adenoma without familial adenomatous polyposis and small bowel neoplasia. Methods: 14 (8 women, 6 men, 67 G 10 years) patients with non-papillary duodenal adenomas without familial adenomatous polyposis were prospectively evaluated. All patients underwent wireless capsule endoscopy. We compared the results of this group with an ageand sex-matched cohort of patients undergoing capsule endoscopy for suspected small bowel disease. Results: Capsule endoscopy was carried out without complications in all cases. At capsule endoscopy, polyps were found in 4 (26%) patients in the study group and no polyp was found in the control group. All detected polyps was very small with no macroscopic view of malignancy. Other pathological findings were angiodysplasias in two patients in the study group. In the control group capsule endoscopy found angiodysplasia in 5 patients and inflammatory lesions in 2 patients. In none of the patients with small bowel polyps detected by capsule endoscopy, management was altered due to polyp formation. Conclusion: 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 management was altered. Follow-up data of these patients will be needed. Abstracts