원발성 소장종양의 임상적 고찰

Abstract

Background/Aims: Primary neoplasms of the small bowel are unusual and constitute 3-6% of all gastrointestinal tract neoplasms. Preoperative diagnostic difficulties, frequent dissemination at the time of the diagnosis, and poor prognosis are characteristics of this pathology. The aim of this study is to increase awareness of small bowel tumor, leading to early detection and itnproved survival. Methods: We reviewed clinical records of 110 cases of primary neoplasms of the small bowel from 1980 to 1994 that were pathologically confirmed. Results: One hundred and ten patients had prirnary neoplasms of small bowel(69 males and 41 females). Their ages ranged from 3 to 81 years(mean 51.3 years). Benign tumors were 15 and malignant tumors were 95. Adenoma was the most frequent benign lesion. Among malignancies, adenocarcinoma was encountered in 43.2%, followed by stromal tutnor(31.6%) and lymphoma(15.8%). The dudenum was most common site involved, followed by jejunum and ileum. Adenocarcinomas were most cornmon in duodenum, stromal tumors and lymphomas were most common in jejunum and ileum, respectively. The most common symptom was aMominal pain, followed by weight loss and gastrointestinal bleeding. The average interval between onset of symptoms and diagnosis was 53.7 days. The most accurate diagnostic method was duodenography in cases of duodenal tumor, srnall bowel series and cornputed tomography in cases of jejunal and ileal tumor, respectively. The operation was performed in 85 patients and only 61 patients underwent curative resection. Conclusions: In case of patients complaining vague and continuous gastrointestinal symptoms, the possibility of small bowel tumor must be considered. If conventional diagnostic methods failed to explain the cause of symptoms, other aggressive tools including enteroclysis, enteroscopy and diagnostic laparotomy should be considered.