Department of Medicine, Division of Gastroenterology; Department of Surgery; School of Medicine; Senior Scholars Program
Diagnosis | Digestive System Diseases | Gastroenterology | Medical Education | Neoplasms | Pathology | Surgical Procedures, Operative
The diagnosis of small-bowel tumors is challenging due to their low incidence, nonspecific presentation, and limitations of traditional endoscopic techniques. In our study, we examined the utility of the mucosal protrusion angle in differentiating between true submucosal masses and bulges of the small bowel on video capsule endoscopy. We retrospectively reviewed video capsule endoscopies of 34 patients who had suspected small-bowel lesions between 2002 and 2017. Mucosal protrusion angles were defined as the angle between the small-bowel protruding lesion and surrounding mucosa and were measured using a protractor placed on a computer screen. We found that 25 patients were found to have true submucosal masses based on pathology and 9 patients had innocent bulges due to extrinsic compression. True submucosal masses had an average measured protrusion angle of 45.7 degrees +/- 20.8 whereas innocent bulges had an average protrusion angle of 108.6 degrees +/- 16.3 (p < 0.0001; unpaired t-test). Acute angle of protrusion accurately discriminated between true submucosal masses and extrinsic compression bulges on Fisher's exact test (p = 0.0001). Our findings suggest that mucosal protrusion angle is a simple and useful tool for differentiating between true masses and innocent bulges of the small bowel.
small-bowel bulge, small-bowel mass, video capsule endoscopy
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Copyright © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
DOI of Published Version
J Clin Med. 2019 Mar 27;8(4). pii: jcm8040418. doi: 10.3390/jcm8040418. Link to article on publisher's site
Journal of clinical medicine
Min, May; Noujaim, Michael; Green, Jonathan; Schlieve, Christopher R.; Vaze, Aditya; Cahan, Mitchell A.; and Cave, David R., "Role of Mucosal Protrusion Angle in Discriminating between True and False Masses of the Small Bowel on Video Capsule Endoscopy" (2019). University of Massachusetts Medical School. Senior Scholars Program. Paper 273.
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