Small bowel tumors in oncology practice and emergency surgery

1982 ◽  
Vol 63 (3) ◽  
pp. 59-60
Author(s):  
Yu. A. Bashkov ◽  
I. A. Tangina ◽  
S. V. Batov
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Emergency Surgery ◽  
Specific Weight ◽  
Abdominal Tumor ◽  
Small Bowel Tumors ◽  
Colon Tumors ◽  
Results Of Treatment ◽  
Significant Difference ◽  
Oncology Practice

In the structure of diseases of the small intestine, tumor lesions have a small specific weight, but in terms of their severity and unsatisfactory results of treatment they deserve special attention. We have observations of 26 patients with small intestine tumors. 14 people were admitted urgently, 12 were hospitalized for examination in connection with the assumption of an intra-abdominal tumor. There were 14 women, 12 men; the age of patients is from 17 to 68 years, of which almost half (12 people) are not older than 40 years. If we take into account that 2/3 and even more patients with malignant colon tumors are older than 40 years, then a significant difference in the contingent of these two groups of patients becomes noticeable

Small Intestine: Neuroendocrine and Miscellaneous Tumors

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  

Video Capsule Endoscopy and Deep Enteroscopy

2017 ◽  
Author(s):  
Neil Marya ◽  
Veronica Baptista ◽  
Anupam Singh ◽  
Joseph Charpentier ◽  
David Cave
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Carcinoid Tumor ◽  
Capsule Endoscopy ◽  
Crohn Disease ◽  
Malignant Tumors ◽  
Video Capsule Endoscopy ◽  
X Rays ◽  
Small Bowel Tumors ◽  
Peutz Jeghers Syndrome

Until 2001, the nonsurgical evaluation of the small intestine was largely limited to the use of radiologic imaging (e.g., small bowel follow-through or enteroclysis). With the now widespread availability of video capsule endoscopy and deep enteroscopy since 2001, we are now able to visualize the length and most of the mucosa of the small intestine and manage small bowel lesions that were previously inaccessible except by surgical intervention. This review serves as an overview for these two procedures, detailing the indications and contraindications, proper timing of the procedure, technical aspects of the devices themselves, possible complications, and outcomes. Figures show endoscopic images that demonstrate multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, severe mucosal scalloping, small bowel carcinoid tumor, small bowel polyp associated with Peutz-Jeghers syndrome, and nonsteroidal antiinflammatory drug enteropathy; serial x-rays of a patient with a patency capsule retained inside the small intestine; a computer image showing the distribution of small bowel tumors; and a pie chart displaying the breakdown of the distribution of benign and malignant tumors that can be found in the small intestine. Videos show multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, small bowel carcinoid tumor, and small bowel polyp associated with Peutz-Jeghers syndrome. This review contains 10 highly rendered figures, 5 videos, and 50 references.

Small Intestine: Neuroendocrine and Miscellaneous Tumors

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  

Long-Term Outcomes after Elective versus Emergency Surgery for Small Bowel Neuroendocrine Tumors

2018 ◽  
Vol 84 (10) ◽  
pp. 1570-1574 ◽  
Author(s):  
Nicholas Manguso ◽  
Alexandra Gangi ◽  
Nicholas Nissen ◽  
Attiya Harit ◽  
Emily Siegel ◽  
...  
Keyword(s):  
Small Bowel ◽  
Lymph Nodes ◽  
Neuroendocrine Tumors ◽  
Emergency Surgery ◽  
Disease Free Survival ◽  
Long Term Outcomes ◽  
Recurrence Rates ◽  
Elective Resection ◽  
Significant Difference

Small bowel neuroendocrine tumors (SBNETs) are often indolent, but occasionally, patients present with acute symptoms requiring emergent operative intervention. Our aim was to determine whether emergency surgery for SBNETs affects long-term outcomes. An institutional database was reviewed to identify patients with SBNET diagnosed between 1990 and 2015. Need for emergency resection (ER) was compared with elective resection (ELR). One hundred and thirty-four patients met inclusion criteria. Median age was 59 years (range, 21–91), and median tumor size was 1.5 cm (range, 0.1–5). Median follow-up time was 5.5 years. One hundred (74.6%) patients had ELR, whereas 34 (25.4%) required ER. ELR had a higher number of lymph nodes resected (median 12.5 vs 8 ER, P = 0.04); however, there was no difference in the number of positive nodes (median 3 vs 2, P = 0.85). There were 45 (33.6%) recurrences (31 [31.0%] ELR vs 14 [41.7%] ER, P = 0.29) and 13 (9.7%) deaths (7 [7.0%] ELR; 6 [17.6%] ER). There was no significant difference in 5-year disease-free survival (ELR 72.6% vs ER 77.9%, P = 0.71) or overall survival (ELR 97.2% vs ER 96.6%, P = 0.81). Although patients undergoing ER have significantly fewer lymph nodes resected, they have comparable recurrence rates and long-term outcomes with those patients undergoing ER.

scholarly journals Surgical treatment of the small intestine atresia under conditions of different postoperative follow-up

2020 ◽  
pp. 7-12
Author(s):  
O. Bodnar ◽  
◽  
L. Vatamanesku ◽  
B. Bodnar ◽  
M. Khoma ◽  
...  
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Small Bowel ◽  
Parenteral Nutrition ◽  
Surgical Department ◽  
Significant Difference ◽  
End To End ◽  
The Difference ◽  
Bowel Atresia ◽  
The City

Introduction. Small intestine atresia is one of the most common causes of low bowel obstruction in newborns. Mortality in this pathology ranges from 5 to 60%, depending on the country. Modern views about surgical correction are rather contradictory. Purpose. To analyze the surgical treatment of small intestine atresia in the surgical department of the City Children’s Hospital No. 1 ССH) (Chernivtsi, Ukraine) and the surgical department Saint Damien Pediatric Hospital NPH (SDH) (Port-o-Prence, Haiti). To determine the best methods of surgery. Materials and methods. The surgical treatment of 15 children under the conditions of SDH (Haiti) and 12 children under conditions of the city children’s clinical hospital (CCH, Chernivtsi) with atresia of the small intestine was analyzed. Determined the effectiveness of closed (oblique «end-to-end» anastomosis, taping with «end-to-end» anastomosis, Denis-Brown and Louw anastomoses), discharging (U- and T-shaped, taping with anostomosing and suspended proximal enterostoma), anastomoses and stomas (end, double, according to Mikulich). Mortality with limited parenteral nutrition was 40% (SDH), with the presence of parenteral nutrition – 33.33% (ССH, Chernivtsi). Results. According to the analyzed data, we believe that the use of the method of surgical treatment should correspond to the type of atresia, the distance of the blind proximal end from the Treitz ligament, the difference in the diameters of the adducting and abducting sections, the possibility of parenteral nutrition, and the threat of short bowel syndrome (SCS). Conclusions. Y-shaped discharging anastomosis «side-to-side» with the removal of the proximal area in the form of a stoma, can be the method of choice in case of significant difference between the intestinal diameters. It provides a wide area of the small bowel junction, chyme abduction until the fistula heals, and can be used for different types of small bowel atresia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Keywords: small intestine atresia, surgical treatment, children.

scholarly journals Small Bowel Intussusception due to Multiple Intestinal Metastases from Lung Adenocarcinoma

2021 ◽  
Vol 18 (3) ◽  
pp. 189-193
Author(s):  
Faten Limaiem ◽  
Saadia Bouraoui
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Lung Adenocarcinoma ◽  
Medical History ◽  
Left Lung ◽  
Adult Intussusception ◽  
Past Medical History ◽  
Small Bowel Tumors ◽  
Surgical Specimen ◽  
History Of

Metastatic small bowel tumors are rare. They often present with small bowel occlusion, bleeding, perforation, or intestinal intussusception. Pulmonary adenocarcinoma with metastasis to the small intestine causing intussusception is exceedingly rare. A 72-yearold male patient with a past medical history of left lung adenocarcinoma, presented to the emergency department with abdominal pain and vomiting. On admission, an X-ray of the abdomen without preparation showed some hydroaeric levels on the small intestine. The abdominopelvic  computed tomography (CT) scan revealed an ileo-ileal invagination, with an image of the invagination rod. The patient underwent a  surgical resection of the small bowel with the removal of the ischemic areas and immediate anastomosis. Macroscopic examination of the surgical specimen revealed five tumor masses varying in size between 1 and 4 cm. The histological examination of the samples taken from these tumors, coupled with an immunohistochemical study confirmed the diagnosis of intestinal metastases of pulmonary origin  expressing cytokeratin 7 (CK7) and thyroid transcription factor 1 (TTF1) but negative for CK20, chromogranin, and synaptophysin. The  postoperative course was uneventful, and the symptoms transiently recovered. However, the patient died 3 months later. We should consider multiple metastatic lesions in adult intussusception, especially in patients with a past medical history of lung cancer.  

scholarly journals Results of diagnosis and surgery of small bowel cancer at Bach Mai Hospital

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Hiếu Học Trần ◽  
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Survival Time ◽  
Preoperative Diagnosis ◽  
Postoperative Mortality ◽  
Bowel Cancer ◽  
Small Bowel Cancer ◽  
Results Of Treatment ◽  
Correct Preoperative Diagnosis ◽  
Small Intestine Cancer

Tóm tắt Đặt vấn đề: Ung thư ruột non là khối u hiếm gặp, thường được chẩn đoán và phẫu thuật ở giai đoạn muộn khi biến chứng đã xảy ra. Nghiên cứu nhằm mô tả đặc điểm lâm sàng, cận lâm sàng, đánh giá kết quả phẫu thuật ung thư ruột non. Phương pháp nghiên cứu: Nghiên cứu mô tả, hồi cứu 45 người bệnh (NB) ung thư ruột non nguyên phát được phẫu thuật tại Bệnh viện Bạch Mai từ 2012 đến 2016. Thu thập các đặc điểm lâm sàng, cận lâm sàng, chẩn đoán trước mổ, mô bệnh học, kết quả điều trị và thời gian sống thêm. Kết quả: 45 NB gồm 23 nam, 22 nữ, hay gặp ở nhóm 41 đến 60 tuổi. Triệu chứng đa dạng, không đặc hiệu và thay đổi theo thể giải phẫu bệnh, có 64,4% chẩn đoán được trước mổ là u ruột non. Chụp cắt lớp vi tính chẩn đoán chính xác 56,7%. Thể saccom cơ trơn gặp nhiều nhất (51,1%), carcinoid gặp ít nhất (4,4%). Kết quả điều trị không có tử vong, 8,9% nhiễm trùng vết mổ. Thời gian sống thêm sau mổ trung bình là 71,1 ± 1,98 tháng, thể ung thư biểu mô tuyến ngắn nhất 22,1 ± 9,5 tháng, thể u carcinoid dài nhất 54,7 ± 12,2 tháng, tuổi >30 tiên lượng tốt hơn nhóm < 30. Kết luận: Ung thư ruột non vẫn còn khó chẩn đoán đúng trước mổ. Điều trị phẫu thuật có hiệu quả tốt và tiên lượng phụ thuộc lứa tuổi và thể mô bệnh học. Abstract Introduction: Small intestine cancer is a rare tumor that is usually diagnosed and operated at a later stage when complications have occurred. Objectives: Describe clinical, subclinical characteristics and surgical results of small intestine cancer. Tạp chí Phẫu thuật nội soi và Nội soi Việt Nam (2020) Số 5 - Tập 10; 27 - 32 27 Kết quả chẩn đoán và điều trị phẫu thuật ung thư ruột non tại Bệnh viện Bạch Mai Trần Hiếu Học và cộng sự Materials and Methods: Descriptive and longitudinal study on 45 patients of primary small bowel cancer operated at Bach Mai Hospital from 2012 to 2016. Data included clinical, subclinical characteristics, diagnosis, histopathology, results of treatment and survival time. Results: The study has 45 patients (23 males and 22 females), most of them aged 41 - 60. Symptoms are diverse, nonspecific and vary according to disease anatomy, correct preoperative diagnosis of small bowel tumor was 64.4% and sensitivity of CT was 56.7%. Frequency of Sarcoma was highest (51.1%) and of carcinoid was least (4.4%). There was no postoperative mortality, 8.9% incision infection. The survival time is 71.1 ± 1.98 months, shortest belongs to carcinoma (22,1 ± 9,5 months) and longest belongs to carcinoid (54,7 ± 12,2 months), prognosis is better in the age group over 30. Conclusions: Proper preoperative diagnosis of small bowel cancer is still difficult. Surgical treatment is effective and prognosis depends on age and histopathology. Keywords: Small bowel cancer, surgery, survival time.

Video Capsule Endoscopy and Deep Enteroscopy

2015 ◽  
Author(s):  
Neil Marya ◽  
Veronica Baptista ◽  
Anupam Singh ◽  
Joseph Charpentier ◽  
David Cave
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Carcinoid Tumor ◽  
Capsule Endoscopy ◽  
Crohn Disease ◽  
Malignant Tumors ◽  
Video Capsule Endoscopy ◽  
X Rays ◽  
Small Bowel Tumors ◽  
Peutz Jeghers Syndrome

Until 2001, the nonsurgical evaluation of the small intestine was largely limited to the use of radiologic imaging (e.g., small bowel follow-through or enteroclysis). With the now widespread availability of video capsule endoscopy and deep enteroscopy since 2001, we are now able to visualize the length and most of the mucosa of the small intestine and manage small bowel lesions that were previously inaccessible except by surgical intervention. This review serves as an overview for these two procedures, detailing the indications and contraindications, proper timing of the procedure, technical aspects of the devices themselves, possible complications, and outcomes. Figures show endoscopic images that demonstrate multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, severe mucosal scalloping, small bowel carcinoid tumor, small bowel polyp associated with Peutz-Jeghers syndrome, and nonsteroidal antiinflammatory drug enteropathy; serial x-rays of a patient with a patency capsule retained inside the small intestine; a computer image showing the distribution of small bowel tumors; and a pie chart displaying the breakdown of the distribution of benign and malignant tumors that can be found in the small intestine. Videos show multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, small bowel carcinoid tumor, and small bowel polyp associated with Peutz-Jeghers syndrome. This review contains 10 highly rendered figures, 5 videos, and 50 references.

scholarly journals Gallstone ileus: a rare cause of small intestine obstruction

2021 ◽  
Author(s):  
Levan Tchabashvili ◽  
Dimitris Kehagias ◽  
Charalampos Kaplanis ◽  
Elias Liolis ◽  
Ioannis Perdikaris ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus

A 77-year-old woman was admitted to our emergency department complaining of abdominal pain. Computed tomography was performed and showed aerobilila and a large 5.1 cm gallstone lodged in the small intestine. She underwent emergency surgery. Intraoperative findings noted small bowel obstruction caused by a large gallstone.

Intussusception in Adults with Small Bowel Tumors

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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