Abstract
Reports of small intestinal tumor diagnosed before surgery have been very rare. In this report, 24 cases of tumors of the small intestine excluding those of the duodenum and the ileocecal valve were studied on their diagnostic procedures. Abdominal pain, melena, nausea and vomiting were common symptoms among them. Intussusception was the most frequent complication. In 12 out of the 24 cases, tumors weredemonstrated by small bowel X-ray study and in four cases by barium enema. Tumors located in the terminal ileum, which were complicated by intussusception, were shown by barium enema. Radiologic features of the tumors were shown in Figure 1 to 7 ; the tumors including lipomas (Figure 1), hemangiomas (Figure 2), a polyp (Figure 3), malignant lymhomas (Figure 4), leiomyosarcomas (Figure 5), metastatic carcinomas (Figure 6) and a primary carcinoma (Figure 7). Tumors were observed by push-type small intestinal endoscopy in four cases and by colonoscopy in two cases ; the tumors including a lipoma (Figure 8), hemangiomas (Figure 9), a malignant lymphoma (Figure 10), a leiomyosarcoma (Figure 11) and a metastatic carcinoma (Figure 12). Characteristics of the radiologic and endoscopic findings of each tumor were discussed with a review of literatures. Among these diagnostic procedures for small intestinal tumors, small bowel X-ray study was the most common and useful method. Small intestinal endoscopy, however, was occasionally more useful for more precise diagnosis of small intestinal tumors such as lipomas, hemangiomas, adenomas and carcinomas. For example, lipomas often showed yellowish color and hemangiomas occasionally showed bluish color through the intestinal mucosa endoscopically. As to epithelial lesions such as adenomas and carcinomas and sometimes non-epithelial lesions like malignant lymphomas, the endoscopic biopsy often provided an accurate histological diagnosis. Although these diagnostic technics were valuable for the diagnosis of small intestinal tumors, it should be emphasized that the most important step for detecting them is a careful analysis of the clinical signs and symptoms.
