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Surgery- UGIT (2) > Tumours Of The Small Bowel > Flashcards

Tumours Of The Small Bowel Flashcards

1
Q

Name 4 benign tumors of the small bowel:

A

Leimyoma
Lipoma
Adenoma
Haemangioma

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2
Q

What is the prevalence of small bowel tumors?

A

These are rare.
They constitute 3% of GIT tumors.
- Malignant tumors account for 64% of small bowel tumors.

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3
Q

What is the prognosis for small bowel tumors?

A

Small bowel tumors have a poor prognosis
Present late with complications.
Characterized by slow growth, remain asymptomatic

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4
Q

Small bowel tumors have a poor prognosis and present with late complications. What is the reason for this?

A
  • Rapid intestinal transit time.
    • Greater fluidity of chyme in the small bowel, may dilute irritants.
    • Greater PH, Low bacterial count
    • High level of benzoyl peroxide (detoxifies potential carcinogens)
    • Inc in IgA and lymphoid tissue
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5
Q

What is a Leiomyoma? Where are they typically found?

A

Incidence is 1-2% of all GIT tumors.

  • This is a benign tumor of the small bowel.
  • It arises from the muscle coat.
  • Usually as a single lesion.
  • Distributed in jejunum and ileum, submucosa , intramural and subserosal.
  • Appear as spherical mass on screen.

Note :- No mesenteric involvement or metastasis.

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6
Q

What is an Adenoma? Where are they typically found?

A

Incidence of 14-20%

  • Usually affect single segment
  • Tubular adenoma’s, affect the villi
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7
Q

What is a Lipoma? Where are they commonly found?

A

This is the 3rd most common benign tumor of the small bowel

  • Fatty lump that is slow growing and rarely carcinogenic.
  • Typically seen in duodenum and distal small bowel.
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8
Q

What is a Haemangioma? Where are they commonly found?

A

Benign vascular tumor.

- Mostly found in the jejunum.

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9
Q

What is another name for polyposis

A

Peutz-Jegners syndrome

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10
Q

What is polyposis?

A

Peutz-Jegners syndrome
This is an autosomal dominant hereditary condition that is associated with an increased risk of developing polyps in the digestive tract, most commonly in the colon and/or rectum
- Melanin spots of oral mucosa, toes and fingers
- multiple polyps in the jejunum
Malignant potential is low

15% may have pigmentation without polyps.

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11
Q

What is another name for Cronkhite syndrome?

A

Canada syndrome.

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12
Q

Name 3 presentations of Canada syndrome:

A

Polyposis
Alopecia
Atrophy of fingernails.

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13
Q

Heterotropic tissues may be an indication of a benign tumor:

A

Heterotropic tissue of the pancreas
- Small submucosal tumors

Endometriosis
- Small mass in the ileum

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14
Q

What is the prevalence of malignant tumors in small tumors malignancies

A

70% of small bowel tumors are malignant.

- 50% of those are advanced by the time they are diagnose.

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15
Q

Give 4 risk factors of developing malignant tumors of the small bowel:

A
  1. FAP (Familial adenomatous polyposis).
  2. IBD (Irritable bowel syndrome).
  3. AIDS.
  4. Neurofibromatosis.
  5. Coeliac disease.
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16
Q

Name 4 kinds of small bowel malignancies

A

Adenocarcinoma’s
Lymphomas
Carcinoids (Neuroendocrine)
Sarcoma’s

17
Q

What is an adenocarcinoma?

A

Adenocarcinoma is a cancer that develops in the glandular tissues of the body.
Theses make up 1% of all primary GIT malignancies.
- Most common Malignant tumor.

18
Q

What section of the small bowel is commonly affected by adenocarcinomas?

A

The duodenum is most commonly affected.

19
Q

What section of the small bowel is commonly affected by adenocarcinoma’s in Chrons disease?

A

Terminal ileum.

20
Q

What is a carcinoid (Neuroendocrine)?

A

A carcinoid is a slow-growing cancerous tumour that can grow in several places throughout the body.
- Often in small intestine.

Remain asymptomatic until metastasis in live.

21
Q

Which cells do carcinoids aide from?

A

Endochromaffin cells.

22
Q

What part of the small bowel are carcinoids commonly found in?

A

Ileum

23
Q

What hormone is secreted by carcinoids (Neuroendocrine)?

A

5-Hydroxytryptamine.

24
Q

What is 5-hydroxytryptamine?

A

This is serotonin
- A Monoamine transmitter
In light of this chapter of work, it is secreted by carcinoids which arise from endochromaffin cells.

25
Q

Name 5 symptoms of carcinoid syndrome:

A 
Diarrhea 
Palpitations 
Flushing 
Bronchospasms 
Congestive cardiac failure
26
Q

How are malignant tumors diagnosed?

A

Diagnosis:

  • 5-HIAA.
  • Octreotide scan.
  • Chromogranin A
27
Q

Name 3 management procedures for malignant small bowel tumors:

A

Surgical resection.
Chemotherapy.
Somatostatin analogues.

28
Q

What is a lymphoma?

A 
Third most common malignant tumor. 
Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes. 
Divided into: 
  - Hodgkin lymphoma’s
  - Non-Hodgkin lymphoma’s

May complicate Coeliac disease

29
Q

Where do primary and secondary lymphomas arise from?

A
  1. Primary: Arises from mucosa-association lymphoid tissue (MALT).
  2. Secondary: Part of systemic lymphatic disease.
30
Q

What are the symptoms of lymphoma development?

A

Fever
Pain
Diarrhea
Weight loss

31
Q

What part of the small bowel is affected by lymphoma’s?

A

Commonly affect the ileum.

32
Q

What is sarcoma of the small bowel?

Give an example of one and mention where they are commonly found?

A 
Sarcoma’s arise from smooth muscle or blood vessels. 
  - An example is a Leiomyosarcoma
These are commonly found in the: 
  - Jejunum and Ileum. 
  - Comomly in Merkel Diverticulum.
33
Q

What is the clinical presentation of malignant tumors of the small bowel?

A 
Weight loss. 
Haemorrhage. 
Colicky abdominal pain. 
Abdominal mass. 
Vomit, diarrhea. 
GIT haemorrhage and Anaemia. 
Duodenal tumors: obstructive jaundice, gastric outlet obstructi9n
34
Q

What diagnostic studies should be used to diagnose a malignant small bowel tumor?

A
  1. CT Enteroclysis.
    • Best gets.
  2. FBC (Full blood count) :- Anaemia.
  3. Small bowel enema.
  4. Double ballon endoscopy.
  5. Video capsule.
  6. Laparotomy
  7. Endoscopy.
35
Q

What is the only hope for a cure for small bowel tumors?

A

Surgery resection

36
Q

Name a few more management options for small bowel tumors:

A 
Surgery resection: Only hope for a cure. 
Surgical enucleation 
Segmental resection: Benign 
Colectomy: For distal ileum tumors 
By-pass surgery 
Adjuvant therapy

Surgery- UGIT (2) (6 decks)

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