Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2017; 23(22): 4121-4126
Published online Jun 14, 2017. doi: 10.3748/wjg.v23.i22.4121
Application of novel magnified single balloon enteroscopy for a patient with Cronkhite-Canada syndrome
Masaki Murata, Shigeki Bamba, Kenichiro Takahashi, Hirotsugu Imaeda, Atsushi Nishida, Osamu Inatomi, Tomoyuki Tsujikawa, Ryoji Kushima, Mitsushige Sugimoto, Akira Andoh
Masaki Murata, Shigeki Bamba, Kenichiro Takahashi, Hirotsugu Imaeda, Atsushi Nishida, Osamu Inatomi, Akira Andoh, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
Tomoyuki Tsujikawa, Comprehensive Internal Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
Ryoji Kushima, Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
Mitsushige Sugimoto, Division of Digestive endoscopy, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan
Author contributions: Murata M, Bamba S, Takahashi K, Imaeda H, Nishida A, Inatomi O, Tsujikawa T, Kushima R, Sugimoto M and Andoh A collected and analyzed the patient’s clinical data and wrote the paper.
Institutional review board statement: Approval of this case report was not given in advance by the Institutional Review Board of Shiga University of Medical Science.
Informed consent statement: A patient of this case provided informed written consent prior to the endoscopic procedure and treatment.
Conflict-of-interest statement: The magnifying single-balloon enteroscope (SIF Y-0007) was loaned free of charge by the Olympus Corporation.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shigeki Bamba, MD, PhD, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan. sb@belle.shiga-med.ac.jp
Telephone: +81-77-5482217 Fax: +81-77-5482219
Received: January 26, 2017
Peer-review started: February 2, 2017
First decision: February 23, 2017
Revised: March 6, 2017
Accepted: March 30, 2017
Article in press: March 30, 2017
Published online: June 14, 2017
Abstract

We present a case of Cronkhite-Canada syndrome (CCS) in which the entire intestine was observed using a prototype of magnifying single-balloon enteroscope (SIF Y-0007, Olympus). CCS is a rare, non-familial gastrointestinal polyposis with ectodermal abnormalities. To our knowledge, this is the first report showing magnified intestinal lesions of CCS. A 73-year-old female visited our hospital with complaints of diarrhea and dysgeusia. The blood test showed mild anemia and hypoalbuminemia. The esophagogastroduodenoscopy and colonoscopy revealed diffuse and reddened sessile to semi-pedunculated polyps, resulting in the diagnosis of CCS. In addition to the findings of conventional balloon-assisted enteroscopy or capsule endoscopy, magnifying observation revealed tiny granular structures, non-uniformity of the villus, irregular caliber of the loop-like capillaries, scattered white spots in the villous tip, and patchy redness of the villus. Histologically, the scattered white spots and patchy redness of the villus reflect lymphangiectasia and bleeding to interstitium, respectively.

Keywords: Balloon-assisted enteroscopy, Magnified endoscopy, Narrow band imaging, Small intestine

Core tip: While the endoscopic findings using esophagogastroduodenoscopy or colonoscopy of Cronkhite-Canada syndrome (CCS) are common, there have been few reports visualizing the small intestinal lesions of CCS. We have used a prototype of magnifying single-balloon enteroscope and have shown the detailed image of the small intestinal lesions of CCS. We also find some novel findings of CCS, some of which were confirmed by histological analysis. We also present a detailed video of this case.