Small Intestine

Small Bowel Tumor

Rare tumors of the small intestine including adenocarcinoma, carcinoid, and lymphoma.

Overview

Small bowel tumors are rare (3-6% of GI tumors) but diverse: adenocarcinoma, carcinoid (neuroendocrine), GIST, and lymphoma. Diagnosis is often delayed due to vague symptoms and difficulty in imaging the small bowel.

Causes

Crohn's disease (adenocarcinoma risk)
Celiac disease
FAP/Peutz-Jeghers syndrome
Prior radiation
Immunosuppression (lymphoma)

Risk Factors

Crohn's disease
Celiac disease
FAP
Age over 60
Immunodeficiency

Symptoms

Vague abdominal pain

GI bleeding (occult or overt)

Bowel obstruction

Weight loss

Anemia

Palpable mass (advanced)

Diagnosis

CT enterography
Capsule endoscopy
Double-balloon enteroscopy with biopsy
PET-CT
Small bowel series

Treatment Options

1Segmental small bowel resection

2Wide excision with lymphadenectomy

3Chemotherapy (lymphoma)

4Imatinib (GIST)

5Somatostatin analogues (carcinoid)

Surgical Treatment

Segmental small bowel resection with adequate margins and mesenteric lymphadenectomy is the standard for adenocarcinoma and localized carcinoids >2cm. GISTs require complete excision without lymphadenectomy. Primary small bowel lymphoma: often treated with chemotherapy, surgery for complications.

Recovery

Small bowel resection: 4-6 days hospital stay. Early feeding once bowel function returns. Long-term: most patients tolerate limited small bowel resection without nutritional consequences unless extensive.

Prevention

Surveillance for Crohn's disease patients
Treat celiac disease with gluten-free diet
Surveillance for FAP/Peutz-Jeghers

Frequently Asked Questions

Are small bowel tumors common?

No. They account for only 3-6% of GI cancers despite the small bowel making up 75% of GI tract length. They're often diagnosed late due to non-specific symptoms.

Will I have absorption problems after small bowel surgery?

Usually not for limited resections (<100cm). Extensive resection (>200cm) can cause short bowel syndrome requiring nutritional support. The remaining bowel adapts over time.

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Frequently Asked Questions

Are small bowel tumors common?

No. They account for only 3-6% of GI cancers despite the small bowel making up 75% of GI tract length. They're often diagnosed late due to non-specific symptoms.

Will I have absorption problems after small bowel surgery?

Usually not for limited resections (<100cm). Extensive resection (>200cm) can cause short bowel syndrome requiring nutritional support. The remaining bowel adapts over time.