Primary jejunoileal neoplasmas:a review of 60 cases

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:buebuewong
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AIM:Primary neoPlasmas of the jejunum and ileum areinfrequent and lack specific manifestations andinaccessibility of conventional endoscopy,so the diagnosisof these tumors are usually delayed.So far the data ofprimary jejunoileal neoplasmas is still scarce,especially inChinese medical literature in English.There may be somedifferences among the Chinese and the westerners injejunoileal neoplasmas.METHODS:A retrospective analysis was made on clinicafindings and pathological types.RESULTS:Of the 60 patients with jejunal or ilealneoplasmas,the most frequent symptom was abdominalpain (57%),followed by tarry stool (43%) and hematochezia(10 %).Abdominal mass (40%) was the most commonfinding on physical examination,followed by anemia andweight loss (35%).67% of the jejunoileal neoplasms werelocated in the jejunum.Among the malignant neoplasmas(68%),malignant stroma (47%) was most common,whilethe benign stromoma (20%) was the most common benignneoplasmas.Preoperatively,40 patients (67%) werediagnosed as small bowel neoplasmas,of which 34 werefound by enteroclysis.Abdominal mass was shown by CT in18 cases and by ultrasonography in 13.The mean durationof symptoms before diagnosis was 7 months.In 41 patientswith malignant tumors,the duration of symptoms beforediagnosis exceeded 12 months in 21 cases,lymphatic ordistant metastases were found in 26 (63%)cases duringoperation.An emergency laparotomy was performed in 4patients (7%) owing to intestinal obstruction or perforation.CONCLUSION:Primary jejunoileal neoplasmas in Chinesepresent some difference from Westerners on clinical featuresand histopathologic types.Enteroclysis remains the majorrelevant diagnostic procedure in this study,the misdiagnoticrate is high preoperatively due to failure of detection byconventional imaging procedures such as CT andinaccessibility of routine endoscopy.For the suspectedpatients,combined application of aforementioned proceduresmay facilitate early diagnosis.The wireless capsuleendoscopy may improve the diagnostic rate of jejunoilealneoplasmas in the future. AIM: Primary neoPlasmas of the jejunum and ileum areinfrequent and lack specific manifestations and inaccessibility of conventional endoscopy, so the diagnosisof these tumors are usually delayed. So far the data of primary jejunoileal neoplasmas is still scarce, especially inChinese medical literature in English.There may be somedifferences among the Chinese and the westerners in jejunoileal neoplasmas. METHODS: A retrospective analysis was made on clinicafindings and pathological types .RESULTS: Of the 60 patients with jejunal or ilealneoplasmas, the most frequent symptom was abdominal pain (57%), followed by tarry stool (43 %) and hematochezia (10%). Abdominal mass (40%) was the most commonfinding on physical examination, followed by anemia and weight loss (35%). 67% of the jejunoileal neoplasms werelocated in the jejunum. Amm the malignant neoplasmas %), malignant stroma (47%) was the most common, while the benign stromoma (20%) was the most common benignneoplasmas. Preoperatively, 40 patients (67%) weredia gnosed as small bowel neoplasmas, of which 34 were found by enteroclysis. Abdominal mass was shown by CT in 18 cases and by ultrasonography in 13. The mean duration of symptoms before diagnosis was 7 was in. 41. 41 patients with malignant tumors, the duration of symptoms before diagnosis exceeded 12 months in 21 cases, lymphatic ordistant metastases were found in 26 (63%) cases duringoperation. An emergency laparotomy was performed in 4patients (7%) due to intestinal obstruction or perforation.CONCLUSION: Primary jejunoileal neoplasmas in Chinesepresent some difference from Westerners on clinical featuresand histopathologic types. Enteroclysis remains the majorrelevant diagnostic procedure in this study, the misdiagnoticrate is high preoperatively due to failure of detection byconventional imaging procedures such as CT andinaccessibility of routine endoscopy. For the suspected cases patients, combined application of Patents procedures facilitate early diagnosis. wireless capsuleendoscopy may improve the diagnostic rate of jejunoilealneoplasmas in the future.
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