What tumors are found in the small intestine?
Tumors in this area are heterogeneous, and treatment depends on their type. Adenocarcinoma develops from the glandular epithelium and is most often located in the duodenum, closer to the stomach. Neuroendocrine tumors usually arise in the ileum and can grow without symptoms for a long time. Lymphomas of the small intestine are associated with rich lymphoid tissue of the wall and are more common in celiac disease. A separate group consists of gastrointestinal stromal tumors that grow from the muscle layer and are prone to bleeding. There are also benign formations - lipomas, polyps, hemangiomas.
- Adenocarcinoma, most often in the duodenum
- Neuroendocrine tumors of the ileum
- Lymphomas, including those associated with celiac disease
- Gastrointestinal stromal tumors
- Benign polyps and lipomas
- The type of tumor determines treatment tactics
Causes and risk factors
Certain chronic diseases significantly increase the risk. In Crohn's disease, prolonged inflammation of the wall of the small intestine creates conditions for tumor transformation, especially in the ileum. With celiac disease, if a person does not follow a gluten-free diet, the risk of lymphoma increases. Hereditary syndromes with multiple intestinal polyps, including familial adenomatous polyposis and Peutz-Jeghers syndrome, are associated with an increased risk of small intestinal tumors. Smoking, alcohol abuse and excess red and processed meat in the diet play a role.
- Crohn's disease with long-term inflammation
- Celiac disease without diet
- Hereditary polyposis syndromes
- Peutz-Jeghers syndrome
- Smoking and alcohol
- Excess red and processed meat
Symptoms
At an early stage, the complaints are vague: periodic dull or cramping abdominal pain, bloating, nausea, feeling of fullness after eating, loss of appetite and gradual weight loss. The tumor often bleeds little by little and imperceptibly, so the first objective sign is often iron deficiency anemia without an obvious source of blood loss. As the tumor grows, it narrows the intestinal lumen, and signs of obstruction appear: increasing cramping pain, vomiting, bloating, lack of stool and gas. A tumor of the duodenum can cause jaundice.
- Vague abdominal pain and bloating
- Nausea and feeling of fullness
- Decreased appetite and weight loss
- Iron deficiency anemia for no apparent reason
- Hidden blood in the stool, rarely black stools
- Signs of intestinal obstruction
- Jaundice due to duodenal tumor
Diagnostics
Standard studies cover only the edges of the small intestine: gastroscopy reaches the duodenum, colonoscopy - the final ileum. Therefore, for unexplained anemia and pain, special methods are used. CT enterography with contrast filling of the intestine shows thickening of the wall, narrowing of the lumen and the condition of the surrounding tissues. Capsule endoscopy allows you to examine the entire mucosa, but does not allow you to take a biopsy; it is not used if a narrowing is suspected. Balloon enteroscopy provides both examination and biopsy. A blood test, ferritin and stool tests for occult blood complete the picture.
- Complete blood count and ferritin
- Feces for occult blood
- Gastroscopy and colonoscopy to exclude other causes
- CT enterography with contrast
- Capsule endoscopy
- Balloon enteroscopy with biopsy
- Prevalence survey
Treatment and prevention
The main method for localized tumors is surgical removal of the affected area of the intestine with surrounding lymph nodes and restoration of the continuity of the digestive tract. For tumors of the duodenum, the scope of the operation is much wider due to the proximity of the pancreas and bile ducts. After surgery, for advanced stages, chemotherapy is prescribed, and for stromal tumors and lymphomas, specific treatment regimens are used. Prevention comes down to control of underlying diseases: treatment of Crohn's disease, a strict gluten-free diet for celiac disease and monitoring for polyposis syndromes.
- Removal of the affected area of the intestine with lymph nodes
- Extended operations for duodenal tumors
- Chemotherapy for advanced stages
- Specific therapy for stromal tumors and lymphomas
- Controlling Crohn's disease
- Strict gluten-free diet for celiac disease
- Observation for hereditary polyposis syndromes
