Tumores Malignos do Intestino Delgado
DOI:
https://doi.org/10.32635/2176-9745.RBC.1987v33n3.3214Keywords:
Intestinal Tumours, Cancer of the Small BowelAbstract
Primary malignant tumours of the small intestine are uncommon and are often diagnosed at na advanced stage. Seventeen cases of malignant tumours of the small intestine were encountered over a 27-year period in the Serviço de Cirurgia from Ribeirão Preto. The ileum was the most common location, with a decreasing frequency proximally. Synchronous tumours were found in 35.29% of the patients. Presenting signs and symptoms were vague and related mainly to abdominal pain (94.12%), nausea and vomiting (52.94%), weight loss (52.94%), and anorexia (35.29%). An abdominal tumour was evident in 35.29910 of patients. Three patients presented with perforation of the tumour, one of them af ter radiotherapy. Barium contrast examination was the primary complementary diagnostic modality. The treatment was wide resection of bowel and mesentery, whenever possible, for jejunal and ileal tumours, together with resection of other involved organs. In one case only biopsy could be perforrned. Lymphoma was the most common malignancy, followed by leiomyosarcoma and adenocarcinoma. The operative mortality was 23.53% (4 patients), 3 from sepsis (two opera ted on with peritonitis) and one from anesthetic problem. Adjuvant radiotherapy and/or chemotherapy was used in the patients who survived surgery except in one. AlI leiomyosarcoma recurred and the patients were opera ted on again with a new resection. Four patients are alive from 2 to 15 years af ter surgery The 5-year survival rate for the lymphomas is 25% (38% if the operative deaths are excluded), and for the adenocarcinoma is 100% (only 2 cases). Whereas the symptoms are vague, the diagnostic of small bowel tumour must be cogitated if the prognosis is to be improved.
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