Tumor of the small intestine

Tumors of the small intestine account for 1-5% of gastrointestinal tumors.

Benign tumors include leiomyomas, lipomas, neurofibromas and fibromas. All of them can cause bloating, pain, bleeding, diarrhea and in case of obturation - vomiting. Polyps are not as characteristic as for the large intestine.

Adenocarcinoma as a malignant tumor is not characteristic. Usually it develops in the duodenum or proximal part of the jejunum and causes minimal signs. In patients with Crohn's disease, tumors tend to develop distally and in disconnected and inflamed bowel loops; adenocarcinoma develops more often with Crohn's disease of the small intestine than with Crohn's disease of the colon.

Primary malignant lymphoma develops in the ileum and is manifested by an extended rigid segment of the intestine. Lymphomas of the small intestine often occur with prolonged course of untreated celiac disease.

Carcinoid tumors develop most often in the small intestine, especially the iliac and vermiform appendages, and are often malignant in this localization. Multiple tumors are observed in 50% of cases. With a tumor larger than 2 cm in diameter, 80% is metastasized regionally, and by the time of surgery - in the liver. Approximately 30% of small intestinal carcinoids cause obstruction, pain, bleeding, or carcinoid syndrome. Treatment consists of surgical resection; may require repeated operations.

Kaposi's sarcoma, described initially as a disease of elderly Jewish and Italian men, develops in aggressive form in Africans, recipients of the transplant and in patients with AIDS, in whom 40-60 % had previous gastrointestinal lesions. The disease can develop in any part of the gastrointestinal tract, but usually in the stomach, small intestine or distal colon. Gastrointestinal diseases usually occur asymptomatically, but bleeding, diarrhea, enteropathy with protein loss and intussusception may develop. The second primary intestinal malignancy develops in <20% of patients; most often it is lymphocytic leukemia, non-Hodgkin's lymphoma, Hodgkin's disease or gastrointestinal adenocarcinoma. Treatment depends on the type of cells, localization and degree of injury.

Diagnosis and treatment of small bowel tumors

Enteroclysm is probably the main study of bulk lesions of the small intestine. Balloon endoscopy of the small intestine with enteroscopy for visualization and biopsy of the tumor can be used. Video endoscopy with a capsule helps to identify damage to the small intestine, especially bleeding sites; The swallowed capsule transmits 2 images per second to an external recording device. The use of a capsule for the study of the stomach and colon is inexpedient, since the capsule is flipped in these large organs.

Treatment consists in surgical resection. Electrocoagulation, thermal obliteration or laser phototherapy during enteroscopy or during surgery may be an alternative to resection.

[1], [2], [3], [4]