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Small-bowel tumors

A J Minardi1, G B Zibari, D F Aultman

  • 1Department of Surgery, Louisiana State University Medical Center-Shreveport, 71130, USA.

Journal of the American College of Surgeons
|June 19, 1998
PubMed
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Small-bowel tumors are challenging to diagnose due to delayed presentation and vague symptoms. Early exploratory surgery is crucial for improving survival rates in patients with these rare gastrointestinal malignancies.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Diagnostic Imaging

Background:

  • Small-bowel tumors are rare, often presenting late, and difficult to diagnose.
  • This study addresses the diagnostic challenges and outcomes associated with small-bowel tumors.

Purpose of the Study:

  • To retrospectively analyze the clinical presentation, diagnosis, treatment, and outcomes of small-bowel tumors.
  • To highlight the difficulties in diagnosing small-bowel neoplasms and suggest improvements.

Main Methods:

  • Retrospective review of 85 patients with 89 small-bowel tumors (primary malignant, primary benign, metastatic) over a 10-year period.
  • Analysis of presenting signs, symptoms, diagnostic modalities (esophagogastroduodenoscopy, CT), surgical interventions, and survival rates.

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Main Results:

  • Metastatic tumors comprised nearly 50% of all small-bowel tumors.
  • Abdominal pain and nausea/vomiting were common symptoms; benign tumors often presented with hemorrhage, metastatic with obstruction.
  • The 5-year survival rate for primary malignant small-bowel tumors was 36%.

Conclusions:

  • Small-bowel tumors present diagnostic challenges due to delayed presentation, nonspecific symptoms, and limited diagnostic accuracy.
  • A high index of clinical suspicion and early exploratory celiotomy are recommended to improve patient survival.