Shenoy, A.H.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA101
Academic Journal
Aim: To study the clinical features and outcomes of small bowel tumours (SBT) presenting to a district general hospital in the Northwest. Methods: We serve a population of 160 000. From Jan 1994 to Dec 2001,36 cases of SBT were identified from pathology database. Cases were excluded if the small bowel lesion was hyperplastic or if it was due to spread of malignancy of an adjacent organ. Results: Mean age was 68.1 years (range 32-91). Majority were females (61.1%). 34 were Caucasians and 2 were Asians. 29% were asymptomatic, 26% had iron deficiency anaemia (IDA), 11% pain abdomen, 11% obstructive jaundice, 4% vomiting, 4% haematemesis, and 4% mass. None had coeliac disease or inflammatory bowel disease. One had known polyposis syndrome (FAP). 60% were diagnosed at gastroscopy, 13% at laparotomy, 10% on ERCP, 10% on contrast study, and 7% on ultrasound. The small bowel lesions included 6 non-neoplastic lesions (2 Brunner's gland hamartoma, 2 gastric heterotropia, 1 myoepithelial hamartoma, and 1 heterotrophic pancreas); 11 benign primary tumours (7 adenoma, 2 lipoma, 1 carcinoid, and 1 angiofibrolipoma); 3 seconday malignancies (2 from past colon cancer and 1 from choroid melanoma); and 16 primary malignancies. Primary malignancies were adenocarcinoma 10 (63%), lymphoma 2 (13%), carcinoid 2 (13%), gastrointestinal stromal tumour 1, and small cell carcinona 1. Site of tumour in 16 cases were duodenum (9), ileum (4), jejunum (3) and duodena-jejunal flexure (1). Symptoms included weight loss (22%), pain abdomen (21%), obstructive jaundice (16%), IDA (16%), abdominal mass (16%), and vomiting (7%). It took a mean of 24.8 weeks (range 1-156) to achieve the diagnosis from the onset of symptoms and a mean time of 7.8 weeks (range 1-28) from presentation to diagnosis. 8 had laparotomy, 7 had resection (6 complete end 1 partial), and 1 was inoperable. There were 3 peri-operative deaths. Lymphoma cases had chemotherapy. Among the 5 survivors, all of who had complete...


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