Jejuno-Ileal tumors: a retrospective study
DOI:
https://doi.org/10.18203/2349-2902.isj20214004Keywords:
Jejunoileal, Small bowel, TumorsAbstract
Background: Primary tumors of the jejunum and ileum are rare and this segment of gastrointestinal tract is relatively inaccessible to conventional endoscopy, leading to a delay in diagnosis. Due to its rarity, data of primary jejunoileal tumors is still scarce, especially in India where diagnostic modalities like capsule endoscopy is not widely available. Herein we aim to discuss the clinico-radiologic findings, pathology and surgical management of such tumors.
Methods: Of the total 51 small bowel resections done in our institute during the period from year 2012 to 2015, 14 patients were identified who were diagnosed with jejunoileal benign/malignant jejunoileal tumors. Records were analysed with respect to patient demographic data, clinical features, radiologic findings, surgical management, histopathology and postoperative outcomes.
Results: Jejunoileal tumors are more common in males (77%) and first presentation was intestinal obstruction (50%) in majority of patients. A definite preoperative diagnosis based on radiologic/endoscopic means was possible in six patients (46%). Patients were operated and laparoscopic group showed superior outcomes in terms of postoperative complications.
Conclusions: Jejunoileal tumors are an infrequent finding in surgical practice. In our study malignant tumors were more common in proximal small bowel. Computed tomography (CT) enterography can detect small bowel lesions with low sensitivity but allows evaluation of lymphadenopathy/distant metastasis. Laparoscopic resection allows initial staging and has the advantage of early recovery, less wound infection rates and better cosmesis.
References
Ashley SW, Wells SA. Tumors of the small intestine. Semin Oncol. 1988;15:116-28.
Minardi AJ, Zibari GB, Aultman DF, McMillan RW, McDonald JC. Smal-bowel tumors. J Am Coll Surg. 1998;186:664-8.
Arber N, Neugut AL, Weinstein IB, Holt P. Molecular genetics of small bowel cancer. Cancer Epidemiol Biomakers Prev. 1997;6:745-8.
Calman KC. Why are small bowel tumours rare? An experimental model. Gut. 1974;15:552-4.
Lowenfels AB. Why are small-bowel tumours so rare? Lancet. 1973;1(7793):24-6.
Taggart DP, Imrie CW. A new pattern of histologic predominance and distribution of malignant diseases of the small intestine. Surg Gynecol Obstet. 1987;165:515-8.
Yang YS, Huang QY, Wang WF, Sun G, Peng LH. Primary jejunoileal neoplasms: a review of 60 cases. World J Gastroenterol. 2003;9:862-4.
Maglinte DD, O’Connor K, Bessete J, Chernish SM, Kelvin FM. The role of the physician in the late diagnosis of primary malignant tumors of the small intestine. Am J Gastroenterol. 1991;86:304-8.
Miles RM, Crawford D, Duras S. The small bowel tumor problem: an assessment based on a 20-year experience with 116 cases. Ann Surg. 1979;189:732-40.
Minardi AJ Jr, Zibari GB, Aultman DF, McMillan RW, McDonald JC. Smal-bowel tumors. J Am Coll Surg. 1998;186:664-8.
Ostermiller W, Joergenson EJ, Weibel L. A clinical review of tumors of the small bowel. Am J Surg. 1966;111:403-9.
Renehan AG, Tyson M, Egger M. Body-mass index and incidence of cancer: systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569-78.
Masselli G, Polettini E, Casciani E. Small bowel neoplasms: prospective evaluation of MR enteroclysis. Radiology. 2009;251(3):743-50.
Maieron A, Hubner D, Blaha B. Multicenter retrospective evaluation of capsule endoscopy in clinical routine. Endoscopy. 2004;36(10):864-8.
Barkin JS, O’Loughlin C. Capsule endoscopy contraindications: complications and how to avoid their occurrence. Gastrointest Endosc Clin North Am. 2004;14(1):61-5.
Zollinger RM. Primary neoplasms of the small intestine. Am J Surg. 1986;151654-8.
Cunningham JD, Aleali R, Aleali M, Brower ST, Aufses AH. Malignant small bowel neoplasms: histopathologic determinants of recurrence and survival. Ann Surg. 1997;225300-306.
Ojha A, Zacherl J, Scheuba C, Jakesz R, Wenzl E. Primary small bowel malignancies: single-center results of three decades. J Clin Gastroenterol. 2000;30289-93.
