Small intestine tumors: what is it, causes, symptoms, treatment, frequency, diagnosis, benign, malignant

Tumors of the small and large intestine are pathological neoplasms formed as a result of cell hyperplasia. They can be benign (change in the rate of mitosis or growth), or malignant (impaired maturation). Tumors of the small intestine are relatively rare - about 3.5% of all gastrointestinal cancers. The outcome depends on timely diagnosis, treatment, degree of malignancy, stage of pathology.

Benign tumors

Non-malignant tumors of the small intestine are neoplasms that develop at different levels of the wall of the duodenum, ileum and jejunum of the intestine. They are characterized by slow growth and a relatively favorable outlook.

Reasons for development

The etiology and pathogenesis of noncancerous tumors of the small intestine remain not fully understood.

It is assumed that the causes of pathological tissue proliferation are:

• improper nutrition;
• enteritis;
• mucosal injury;
• invasive intervention on the organs of the digestive system;
• genetic predisposition.

The likelihood of a similar pathology of the small intestine increases with poor functioning of the immune system, exposure to adverse factors (work with toxins), alcoholism, smoking, weak peristalsis, dr.

Varieties

Small intestinal neoplasms can begin to develop from any layer of the intestinal wall - epithelium, smooth muscles, connective, nervous or vascular tissue. In accordance with the histological structure, the types of neoplasms listed in the table are distinguished.

Tumor formations can grow into the lumen of the small intestine (exophytic) or outward, towards other organs (endophytic).

Clinical picture

Benign tumors of the small intestine differ in the nature of the clinical course, depending on the period of development of the disease:

• latent (incubation) - asymptomatic period;
• prodromal - the appearance of individual nonspecific signs of the disease is possible;
• stage of pronounced clinical manifestations.

At the initial stages of the development of a tumor of the small intestine, there are no symptoms. It can be discovered by chance during an examination for another disease. The progression of the process is manifested by the appearance of general clinical signs of gastrointestinal disorders:

• discomfort in the abdomen;
• nausea;
• accumulation of gases inside the intestinal cavity;
• decreased appetite;
• needless weight loss;
• violation of defecation;
• periodic painful sensations.

At the stage of a pronounced clinic, bleeding (latent or explicit) joins the overall picture. Anemia is determined by laboratory tests. Obturation of the lumen with a tumor leads to obstruction, cramping pains, urge to vomit appear.

Emetic discharge may consist of feces (with bowel obstruction). With some types of small intestinal neoplasms, extraintestinal signs appear:

• alopecia;
• dark spots;
• destruction of nails;
• hypoglycemia;
• weakness;
• hypotension, etc.

Diagnostics and treatment

The diagnosis of a benign tumor of the small intestine is made on the basis of x-rays taken with the passage of barium through the intestines. Among the others survey methods with suspicion of oncology, the following are popular:

• probe enterography;
• irrigography;
• enteroscopy (jejunoscopy, ileoscopy);
• Ultrasound scanning of the abdominal organs;
• scintigraphy;
• laparoscopy;
• CT, MRI.

During endoscopic examination, tissue biopsy can be performed for histological analysis for the purpose of morphological verification of the formation.

Treatment of the disease is invasive. The intervention protocol depends on the localization of the formation, its size, type. It is possible to use such methods:

1. Electrocoagulation. It is carried out endoscopically. It is used to cauterize small growths that are localized in the reach of the endoscope.
2. V-shaped excision (for small tumors).
3. Resection of a section of the intestine (with masses).

Malignant tumors

Malignant tumors (cancer) of the small intestine are neoplasms that form as a result of the division of immature cellular elements or during the malignancy of benign tumors. This is a rare pathology - it occurs in 0.1% of cases of diagnostics of pathological formations of the small intestine.

Etiology

It is reliably known that the neoplastic process develops against the background of enzyme disorders and inflammatory disorders of the digestive tract. The most common precursors of a cancer of the small intestine are the following pathologies:

• duodenal ulcer;
• duodenitis;
• enteritis;
• Crohn's disease;
• diverticulitis;
• nonspecific ulcerative colitis;
• adenomatous polyps.

The development of the disease is facilitated by:

• nicotine, alcohol addiction;
• eating fried foods, carcinogenic foods;
• ionizing radiation.

Classification and stages

The histological typology is shown in the table.

Among malignant neoplasms of the small intestine, there are also undifferentiated and unclassified tumors. In addition, pathologies can develop secondarily due to metastases from other organs (mammary glands, stomach, uterus, dermis, lungs).

There are 4 stages of the development of the disease:

• I - <20 mm, not extended to other tissues;
• II - the beginning of invasion into adjacent tissue layers and adjacent organs;
• III - significant growth, penetration into the lymph nodes;
• IV - hematogenous, lymphogenous metastasis, development of secondary foci.

Symptoms

At the initial stages of neoplasia of the small intestine, they have scanty symptoms. There are no specific signs in the early stages. The first pathological criteria appear in the prodromal period:

• dyspepsia (belching, food aversion, frequent vomiting, weight loss);
• difficulty in passing gases;
• abdominal pain;
• upset stool (often alternating constipation with diarrhea);
• pale skin color, dizziness, lethargy;
• anemia that cannot be corrected;
• dark or black feces (due to the presence of occult blood);
• mucus in stool;
• subfebrile temperature.

In the terminal stage, the tumor of the small intestine significantly grows into the surrounding tissues. The clinical picture becomes pronounced - pain intensifies, they become constant, often burning. The formation is palpated on palpation.

There is a prolonged retention of gas and stool. If the bladder is affected, there is difficulty in urinating. If the neoplasm has grown into the uterus or vagina in women, then feces may be excreted from the genitals.

Treatment

For the diagnosis, the same methods are used as for the diagnosis of benign neoplasms. Treatment is individual in nature, selected depending on the severity of the patient's condition, stage of development of the process, its localization, prevalence.

The main method is the surgical removal of the formation. Chemotherapy, radiotherapy is used in the presence of a tumor sensitive to such techniques.

Conclusion

Oncopathologies of the small intestine are rare. Their insidiousness lies in the absence of symptoms at the initial stage. Because of this, the diagnosis is often made in the later stages, when the formation is large and less responsive to treatment.

Noncancerous tumors, as a rule, in most cases have a milder course and a relatively favorable prognosis. Malignant neoplasias often end in complications, and if treatment is started late, then in 70% of cases, a lethal outcome is possible.

Tumor processes in the small intestine are severe pathologies, a successful cure from which is possible only with timely detection. Treatment of diseases is mainly surgical. In order not to miss the beginning of the development of the neoplastic process, it is necessary annually (especially after 40 years) to undergo a preventive examination by a proctologist surgeon and do an ultrasound of the abdominal cavity.

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Sources of information

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