Value of Double-Balloon Enteroscopy in Diagnosing Alimentary Tract Hemorrhage Induced by Stromal Tumor of Small Bowel

Objective To investigate the diagnostic value of double balloon enteroscopy(DBE) in diagnosing alimentary tract hemorrhage induced by stromal tumor of small bowel(STSB) and analyze the morphological features of small bowel under endoscopy. Methods We retrospectively analyzed the clinical manifestation, endoscopic appearance, tumor size, location, imageological characteristics and postoperative pathological diagnosis data of 40 patients with alimentary tract hemorrhage induced by STSB. Results Alimentary tract hemorrhage induced by STSB was more common in the elderly (50.50±10.21) year-old) , with melena, bloody stool or positive in occult test as the main characteristics, and mostly suffered from anemia, abdominal pain, distension and loss of body weight. Lesion was detected by abdomen CT or angiography prior to DBE in 15.00% (6/40) of patients; 95.00% (38/40) stromal tumor of small intestine was detected by DBE; 5.00%(2/40) of the patients was missed diagnosis. Stromal tumor appeared as hard, spherical or hemispherical submucosal protrusion with clearly demarcated borders. The mucosal was intact or of superficial erosion, with part of luminal narrowing. Risk factors were defined after the operation: very low risk (6 cases), low risk (15 cases), intermediate risk (13 cases) and high risk (6 cases). Conclusion DBE is an effective and safe method for identifying STSB, however, it still has limitations in evaluating the invasion risk and clinical prognosis. For early detection, accurate clinical evaluation and prognosis of STSB combined with other diagnostic information, further studies will be needed.