Small-Bowel Neoplasms: Role of MRI Enteroclysis

Small-bowel neoplasms are the 3%–6% of all gastrointestinal tract neoplasms. Due to the rarity of these lesions, the low index of clinical suspicion, and the inadequate radiologic examinations or incorrect interpretation of radiologic findings, a delay in diagnosis of 6–8 months from the first symptoms often occurs. Even if conventional enteroclysis and capsule endoscopy are the most common procedures used to accurately depict the bowel lumen and mucosal surface, their use in evaluating the mural and extramural extents of small-bowel tumors is limited. Instead multidetector computed tomographic enteroclysis and magnetic resonance enteroclysis have the potential to simultaneously depict intraluminal, mural, and extraintestinal abnormalities. In particular MR enteroclysis has an excellent soft tissue contrast resolution and multiplanar imaging capability. It can provide anatomic, functional, and real time information without the need of ionizing radiation. MR findings, appearances of the lesions, combined with the contrast-enhancement behavior and characteristic of the stenosis are important to differentiate small-bowel neoplasm from other nonneoplastic diseases.

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Jejuno-Ileal tumors: a retrospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20214004 ◽

2021 ◽

Vol 8 (10) ◽

pp. 3109

Author(s):

Mohim Thakur ◽

Ravinder Vats ◽

Deep Goel ◽

Virandera P. Bhalla

Keyword(s):

Small Bowel ◽

Surgical Management ◽

Malignant Tumors ◽

Demographic Data ◽

Laparoscopic Group ◽

Early Recovery ◽

Primary Tumors ◽

Delay In Diagnosis ◽

Radiologic Findings ◽

Proximal Small Bowel

Background: Primary tumors of the jejunum and ileum are rare and this segment of gastrointestinal tract is relatively inaccessible to conventional endoscopy, leading to a delay in diagnosis. Due to its rarity, data of primary jejunoileal tumors is still scarce, especially in India where diagnostic modalities like capsule endoscopy is not widely available. Herein we aim to discuss the clinico-radiologic findings, pathology and surgical management of such tumors. Methods: Of the total 51 small bowel resections done in our institute during the period from year 2012 to 2015, 14 patients were identified who were diagnosed with jejunoileal benign/malignant jejunoileal tumors. Records were analysed with respect to patient demographic data, clinical features, radiologic findings, surgical management, histopathology and postoperative outcomes.Results: Jejunoileal tumors are more common in males (77%) and first presentation was intestinal obstruction (50%) in majority of patients. A definite preoperative diagnosis based on radiologic/endoscopic means was possible in six patients (46%). Patients were operated and laparoscopic group showed superior outcomes in terms of postoperative complications. Conclusions: Jejunoileal tumors are an infrequent finding in surgical practice. In our study malignant tumors were more common in proximal small bowel. Computed tomography (CT) enterography can detect small bowel lesions with low sensitivity but allows evaluation of lymphadenopathy/distant metastasis. Laparoscopic resection allows initial staging and has the advantage of early recovery, less wound infection rates and better cosmesis.

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T1860 Magnetic Resonance Enteroclysis in the Diagnosis of Small Bowel Neoplasms: A Retrospective Evaluation of 91 Studies

Gastroenterology ◽

10.1016/s0016-5085(08)62701-8 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-578

Author(s):

Stijn J. Van Weyenberg ◽

Mike E. Craanen ◽

Maarten A. Jacobs ◽

Donald L. Van der Peet ◽

Cornelis Van Kuijk ◽

...

Keyword(s):

Magnetic Resonance ◽

Small Bowel ◽

Retrospective Evaluation ◽

Magnetic Resonance Enteroclysis ◽

Small Bowel Neoplasms

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Intussusception in Adults with Small Bowel Tumors

Gastroenterology ◽

10.1016/s0016-5085(49)80039-4 ◽

1949 ◽

Vol 12 (2) ◽

pp. 290-301

Author(s):

Robert M. Lowman ◽

William Mendelsohn

Keyword(s):

Small Bowel ◽

Small Bowel Tumors

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Radiologic findings of small bowel rupture due to blunt abdominal trauma

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1987.23.2.268 ◽

1987 ◽

Vol 23 (2) ◽

pp. 268

Author(s):

H K Ha ◽

Y W Bahk

Keyword(s):

Small Bowel ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Radiologic Findings

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The impact of magnetic resonance in the preoperative staging and the surgical planning for treating small bowel neoplasms

Surgery Today ◽

10.1007/s00595-012-0270-1 ◽

2012 ◽

Vol 43 (6) ◽

pp. 613-619 ◽

Cited By ~ 12

Author(s):

Giuseppe Pappalardo ◽

GianFranco Gualdi ◽

Aldo Nunziale ◽

Gabriele Masselli ◽

Irene Floriani ◽

...

Keyword(s):

Magnetic Resonance ◽

Small Bowel ◽

Surgical Planning ◽

Preoperative Staging ◽

Small Bowel Neoplasms ◽

The Impact

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Small Intestine: Neuroendocrine and Miscellaneous Tumors

10.2310/cgso.16093 ◽

2017 ◽

Author(s):

Joel M Baumgartner ◽

Sudeep Banerjee ◽

Jason K Sicklick

Keyword(s):

Small Intestine ◽

Small Bowel ◽

Surgical Intervention ◽

Distant Metastases ◽

Somatostatin Analogues ◽

Locoregional Therapy ◽

Small Bowel Tumors ◽

Small Bowel Tumor ◽

Key Words Carcinoid Tumor ◽

A Site

Carcinoid tumors are the most common nonduodenal small bowel tumors. Although the diagnosis of any small bowel tumor is challenging, serum tumor markers and specialized imaging can aid in the diagnosis of carcinoid. Localized carcinoids are treated with surgical resection, whereas metastatic tumors are treated with somatostatin analogues, although liver-directed therapies can improve disease-related symptoms. In contrast, small bowel lymphomas are primarily treated with chemotherapy and sometimes radiation, although surgical intervention may be necessary for diagnosis and resection for palliation of symptoms. Furthermore, there are many benign etiologies of small bowel tumors, including adenoma, leiomyoma, and lipoma. The small bowel can also be a site of distant metastases for which surgical management is reserved for the treatment of complications such as bleeding, obstruction, perforation, or pain. This review contains 3 figures, 3 tables and 17 references. Key words: carcinoid tumor, desmoid tumor, locoregional therapy, mesentery, neuroendocrine tumor, small bowel, small bowel lymphoma, somatostatin

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Duodenal Malignancies

10.2310/7800.16072 ◽

2018 ◽

Author(s):

Emily R Newton ◽

Benjamin H Schmidt ◽

Michael O Meyers

Keyword(s):

Small Bowel ◽

Primary Treatment ◽

Carcinoid Tumors ◽

Adjunctive Treatment ◽

Small Bowel Tumors ◽

Cross Sectional ◽

Carcinoid Crisis ◽

Cross Sectional Imaging ◽

Duodenal Carcinoma ◽

Duodenal Resection

Although malignancies involving the small bowel are rare, one-third of these are located in the duodenum. The majority of duodenal tumors are adenocarcinoma but also may include gastrointestinal stromal tumors (GIST), carcinoid or neuroendocrine tumors, sarcomas, and lymphoma. These commonly present with nonspecific symptoms, but obstructive patterns predominate when symptoms are present. Preoperative diagnosis is made via endoscopy and/or cross-sectional imaging. This section focuses on treatment and surgical management for adenocarcinoma, carcinoid tumors, and GISTs of the duodenum. Surgical resection is the primary treatment of for all three of these, but all have significant nuances in surgical planning and decision-making as well as variability in the role of adjunctive treatment in their management. Functional carcinoid tumors can have hormone-driven symptoms and are associated with an increase in risk of carcinoid crisis, which may be prophylactically treated with intravenous octreotide. Resection of these tumors relies heavily on tumor relationship to the ampulla. Key anatomic distinctions and clinical tips to identify the ampulla to ensure an appropriate duodenal resection are discussed in this review. This review contains 12 figures, 5 tables, and 54 references. Key Words: carcinoid, duodenal carcinoma, duodenal adenocarcinoma, duodenal resection, duodenal tumors, neuroendocrine tumor, gastrointestinal stromal tumor, small bowel tumors

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