home Audience 3 Symptoms of small intestine cancer. Initial signs, symptoms and diagnostic algorithm of small intestine cancer. Reasons for the development of the disease

Symptoms of small intestine cancer. Initial signs, symptoms and diagnostic algorithm of small intestine cancer. Reasons for the development of the disease

The structure of the small intestine is divided into three sections:

the denudal part, the shortest, got its name because of its length, equal to the length of 12 fingers in diameter;
the lean section in the anatomy of the small intestine is due to its relatively small diameter;
the iliac region is located near the iliac fossa, and therefore bears the name, so to speak, because of the location area.

The small intestine, in which food is exposed to the action of intestinal juice, bile, pancreatic juice, is located in the middle region of the abdomen, downward from the stomach and transverse colon. In the small intestine, digestion products are also absorbed into the blood and lymphatic vessels. The length of the small intestine ranges from 2.2 to 4.4 m, its thickness is from 4.5 to 6 cm. The small intestine begins from the pylorus, flows into the caecum in the region of the right iliac fossa. In the structure of the human small intestine, the duodenum, jejunum and ileum are distinguished.

Small intestine cancer and tumor localization

Small intestine cancer in the structure of malignant tumors of the digestive tract is 1-2%. According to ICD-10, it has the code C17.

Due to the blurring of the first symptoms, small intestine cancer is diagnosed by chance, very often during an X-ray examination or abdominal surgery during treatment for another disease. At the same time, metastasis begins, due to which secondary intestinal cancer develops.

The most common neoplasms of the small intestine are:

duodenal cancer (about 50% of cases);
jejunal cancer (30%);
ileum cancer (20%).

It is worth noting! Small bowel cancer mostly affects men over the age of 60 and almost never occurs in people under 50 years of age.

Why are malignant tumors in the small intestine so rare? The contents of the small intestine have a liquid consistency and move very quickly, so it does not irritate the mucous membrane. Carcinogens ingested with food do not have time to harm. There are very few bacteria in the small intestine, but a lot of lymphoid tissue. Alkaline pH and the enzyme benzpyrene hydroxylase are considered as protective factors.

Metastases reach regional lymph nodes and other distant parts of the intestine, so the following may develop:

Causes of small intestine cancer

No specific direct cause of oncology of the small intestine has yet been found. Attention is always drawn to chronic enzymatic or inflammatory bowel disease, cancer symptoms can hide behind signs of diseases such as diverticulitis, ulcerative colitis, enteritis, Crohn's disease, duodenal ulcer. Often, the tumor develops against the background of adenomatous, prone to degeneration into oncogenic.

The duodenum is often affected due to the irritating effect of bile. The initial part of the small intestine is due to pancreatic juice and active contact with carcinogens from food, fried foods, alcohol and nicotine.

Also, the causes of the appearance of a tumor include:

Peutz-Jeghers syndrome;
duodenitis;
celiac disease;
genetic pathologies;
benign tumors;
metastasis of the malignant process to other organs.

The first symptoms and signs of small intestine cancer in men and women

If duodenal cancer is suspected, the first symptoms will be similar to gastric ulcer and duodenal ulcer and will manifest as an aversion to food, dull pain in the epigastric zone with irradiation to the back. At a late stage, duodenal cancer shows symptoms associated with poor patency of the biliary tract and intestines due to tumor growth. The patient will suffer from endless nausea and vomiting, flatulence and manifestations of jaundice.

The jejunum and ileum signals oncology with the first local signs and general dyspeptic disorders:

nausea and vomiting;
bloating;
pain in the intestines;
spasms in the navel and / or epigastric region;
frequent loose stools with mucus.

It has been proven that the symptoms of small intestine cancer are more common in men than in women. This fact is associated with the way of life of men, nutrition and abuse of malicious habits: alcohol, smoking and drugs. In addition, small intestine cancer develops in men somewhat differently due to the different structure of the genitourinary system.

Very often with, there are signs of bowel cancer in women. With tumor metastases, symptoms of bowel cancer in men may appear. If the tumor compresses neighboring organs, then this leads to the development of pancreatitis, jaundice, ascites, intestinal ischemia.

The tumor grows, so the symptoms of cancer in the small intestine increase:

pain during bowel movements;
intestinal patency is disturbed;
there is a clear or hidden intestinal blood loss;
perforation of the intestinal wall develops;
the contents enter the peritoneal cavity and peritonitis begins;
intoxication (poisoning) of the body increases due to ulcers and intestinal fistulas;
iron deficiency increases;
impaired function of the pancreas and liver.

Cancer is not gendered, so the symptoms of bowel cancer in women and men are largely the same:

growing weakness;
weight loss;
malaise;
anemia, rapid and inexplicable fatigue;
neurosis;
anorexia;
difficulty with defecation accompanied by pain;
frequent urge to go to the toilet;
anemia;
pallor of the skin;
dizziness and migraine;
temperature rise.

It is worth noting! Unlike cancer of the small intestine, symptoms of colon cancer can be found in a person regardless of gender and age. The disease is diagnosed even in children, although quite rarely.

Symptoms and signs of small intestine cancer in women and men

The development of the tumor in the early stages in women and men is almost the same. The progression of the tumor and its growth on nearby organs makes a distinction in the symptoms. As the cancer spreads, it primarily affects the vagina in women and the prostate in men. After cancer affects the rectum and sphincter canal, causing complaints in both sexes. There are pains in the anus, lumbar spine, coccygeal region and sacrum. Men experience problems with urination, which indicates damage to the bladder. The body temperature rises significantly, the development of ureteral infections is likely.

Symptoms in stages 3 and 4

Detection of cancer at the last stages of development significantly complicates the treatment process. The collapse of the tumor leads to complete intoxication of the body. Patients feel severe pain that radiates to the lumbar region, sacrum, anus.

At stage 4, symptoms such as:

incessant vomiting;
increased gas formation;
development of jaundice;
intestinal ischemia;
pancreatitis.

Squeezing by the tumor of neighboring organs leads to the occurrence of fistulas and provokes the appearance of the following symptoms of cancer:

Where does small intestine cancer metastasize?

Near the small intestine there are many important organs and when the oncotumor spreads, their damage begins.

Also, cancer cells spread through the blood throughout the body to distant lymph nodes in this case, the following are affected:

Classification of small intestine cancer

Depending on the characteristics of growth, malignant neoplasms are conditionally divided into the following types:

Exophytic - grow inside the intestinal lumen. Cancer processes provoke stagnation of feces in the affected areas of the jejunum, with the development of the disease turning into obstruction. Tumors look like fungi or polyps with well-defined structured borders, becoming saucer-shaped when ulcerated.
Endophytic, or infiltrative. Neoplasms without clearly marked edges are distributed along the walls of the intestine, gradually growing into a distant organ through the lymphatic system. Tumors can lead to rupture of the intestinal wall and hemorrhage.

According to the histological classification, oncological formations of the small intestine are:

- develops from glandular tissue near the large papilla of the duodenum. The tumor is ulcerated and covered with a fleecy surface.
- develops in any part of the intestine, more often - in the appendix. Less often - in the ileum, very rarely - in the rectum. The structure is similar to the epithelial form of cancer.
- rare oncological formation (18%) and combines lymphosarcoma and ().
- a large oncological formation, more than 5 cm in diameter, can be palpated through the wall of the peritoneum. The tumor creates intestinal obstruction, perforation of the wall.

Lymphoma of the small intestine can be primary or secondary. If primary lymphoma of the small intestine is confirmed, the symptoms are characterized by the absence of hepatosplenomegaly, enlarged lymph nodes, changes on the chest x-ray, CT, in the blood and bone marrow. If the tumor is large, there will be disturbances in the absorption of food.

If the retroperitoneal and mesenteric lymph nodes spread tumor cells, then a secondary lymphoma is formed in the small intestine. Small bowel cancers include ring cell, undifferentiated, and unclassified cancers. The growth form is exophytic and endophytic.

Classification of cancer of the horse intestine according to the TNM system

According to the clinical and anatomical classification according to the international TNM system, the following stages are distinguished in the development of small intestine cancer:

T - tumor:

Tis - preinvasive cancer;
T1 - tumor invasion of the submucosal layer of the intestine;
T2 - tumor invasion of the muscular layer of the intestine;
TK - tumor invasion of the subserous layer of the intestine or retroperitoneal space. The tumor is not more than 2 cm;
T4 - germination of the tumor of the visceral peritoneum, non-peritoneal areas with a length. Tumor more than 2 cm.

N - damage to the lymph nodes:

N0 - no lymph nodes affected.
N1 - metastatic lesion of regional lymph nodes.

M - the presence of distant metastases:

M0 - no separated metastasis;
M1 - Distant metastasis is present.

Stages of small intestine cancer

There are five stages of intestinal adenocarcinoma:

Stage 0 or cancer in situ. A solitary small tumor that is located on the surface of the mucous membrane and does not grow deeper. Metastases are absent.
Stage 1 - the tumor has grown deep into the intestinal wall, but has not spread to neighboring organs. Metastases are absent.
In stage 2 bowel cancer, the tumor has grown through the entire thickness of the intestinal wall and spread to neighboring organs.
in stage 3 small bowel cancer, cancer cells have spread to regional lymph nodes. Germination in other organs and distant metastases are absent.
In stage 4 small bowel cancer, there are distant metastases. Most often they are found in the lungs, liver. bones and other organs.

Diagnosis of small bowel cancer

To recognize bowel cancer at an early stage, it is necessary to conduct a series of diagnostic studies that will determine what treatment will be used, the patient's condition and the prognosis for survival.

Diagnosis of small intestine cancer depends on the location of the tumor in the intestine itself:

Fibrogastroduodenoscopy and contrast fluoroscopy, with the help of these methods, the diagnosis of the duodenum is carried out.
Irrigoscopy and colonoscopy - performed to diagnose the ileum.
To detect stenosis and the presence of barriers to the movement of barium sulfate suspension, the method of barium passage in the lumen of the tract is used.

During endoscopy, samples of cancer cells are taken for further laboratory study and confirmation or refutation of the diagnosis.

Metastasis and spread of a cancerous tumor is detected using:

Ultrasound of the peritoneum;
CT scan of the intestinal tract;
chest x-ray;
bone scintigraphy.

If there is any doubt about the diagnosis, laparoscopy is performed along with surgery.

For malignant tumors, the following laboratory tests are performed:

A blood test reveals a decrease in hemoglobin, an increase in ESR, which is typical for any oncological disease.
Biochemistry - when a carcinoembryonic antigen is detected in plasma, a tumor is diagnosed and its stage of development is established.
A toxic compound occurs in the intestinal tract - the substance indican can be detected using a urinalysis.
Blood for the presence - jejunal cancer is likely to be accompanied by markers,.

Based on the analysis of feces, the presence of occult blood in the patient's waste products is revealed.

How to identify bowel cancer, the symptoms of which do not manifest themselves in anything specific? During this period, it is very important to confirm or refute the suspicion of cancer, because the sooner treatment begins, the easier it is for the patient to transfer its stages, the greater the chance of a positive result. When the symptoms appear, the oncoprocess can be considered neglected, and the moment of early treatment will be missed.

Important! Early symptoms include a “malicious” condition that should alert any person - this is an unwillingness to work or do household chores due to increased weakness and fatigue. The skin becomes pale and "transparent". The patient constantly has heaviness in the stomach, he does not want to eat at all. Following this, dyspeptic disorders appear: nausea, vomiting, pain and heartburn, even from water.

What is the diagnosis of small intestine cancer?

When contacting a doctor, a blood test is immediately prescribed and examined, which is necessarily carried out if bowel cancer is suspected. According to the general basic blood test, anemia, the patient's condition, and the presence of inflammation can be detected.

Then, based on the results of the blood test, if necessary, a blood test for small intestine cancer is performed. The most informative and common oncomarkers are alpha-fetoprotein, total/free PSA, CEA, CA 19-9, and cytokeratin.

For example, with the help of tumor markers CA 19-9 and CEA (cancer-embryonic antigen), screening diagnostics of colon cancer is carried out. If CEA is determined, then you can find out the staging before the operation and monitor the patient with a diagnosis of colorectal cancer after it. As the disease progresses, the serum CEA level will rise. Although it may grow and not in connection with the tumor, and in the later stages, colorectal cancer can be detected without an increase in CEA in the blood.

Endoscopic diagnosis, open biopsy of the intestine are the main methods for confirming oncology of the small intestine.

Small bowel cancer treatment

Treatment of cancer of the small intestine, namely the duodenum, jejunum and ileum, is carried out depending on the type of tumor and stage. The main method is bowel resection and removal of oncology.

The volume of surgical intervention depends on the stage of tumor development, its localization and the degree of damage to surrounding tissues, organs and systems. Cancerous tumors at the initial stage are removed using laparoscopic surgery. The operation to remove a tumor of the small intestine is performed through several punctures in the anterior abdominal wall. A laparoscope with an LED is inserted through the puncture, a video camera is also inserted into the puncture, transmitting the entire operation process to the computer screen, with its help the surgeon performs surgical manipulations.

If the tumors are large, which indicates the late stages of cancer development, then in this case, extensive operations are used, which include:

resection of the small intestine, in which the affected section of the small intestine is removed along with the lymph nodes and part of the healthy surrounding tissues;
a radical operation in which tumors of a huge size and all tissues affected by metastases are subject to removal;
contactless operation. Carried out by overlapping all blood and lymphatic vessels around the tumor. Resection is performed to prevent the dispersion of malignant cells throughout the body;
duodenectomy, an operation that is performed for duodenal cancer by resection of the affected area of the small intestine with the subsequent restoration of continuous intestinal patency. The operation is performed independently, as well as in combination with pancreaticoduodenectomy, when pancreatic resection is performed for cancer of the pancreatic head. Along with surgery on a segment of the small intestine, gastrectomy can be performed. In advanced ileal cancer, a hemicolectomy is performed on the right side of the large intestine.

With a confirmed diagnosis of small intestine cancer, surgery reduces symptoms and increases life expectancy. If it is not possible to remove a malignant tumor of the small intestine at a late stage or it is found that the tumor is sensitive to chemotherapy, drugs that prevent the growth of cancer cells are used.

Chemotherapy for small intestine cancer

Chemotherapy for cancer of the small intestine, as an independent method of therapy is considered ineffective. It is prescribed as an additional treatment to reduce the risk of developing metastases and as with. Chemotherapy is used before surgery to reduce the size of the tumor and inhibit the development of cancer cells, after surgery to reduce the risk of tumor recurrence.

After a palliative operation (which alleviates the suffering of the patient), chemotherapy (polychemotherapy) is carried out, but without radiation.

After the operation, an additional diagnosis of intestinal motility is carried out using the method of electrogastroenterography, so that a dangerous complication does not develop - intestinal paresis.

To alleviate the patient's condition after surgery and chemotherapy, complex therapy is introduced: tinctures for alcohol, infusions and decoctions of medicinal herbs, mushrooms and berries. Appropriate prevents paresis, nausea and vomiting, improves gastrointestinal motility.

Prevention of cancer of the small intestine (colon)

It is impossible to reduce the risk of small intestine cancer, but there are a number of preventive measures that help avoid the formation of tumors in the intestine:

regularly undergo preventive examinations;
adhere to the principles of a healthy lifestyle and proper nutrition;
timely treat diseases of the gastrointestinal tract;
annually take a fecal occult blood test (Colon View test, with which you can determine the occult blood in the feces and detect bowel cancer at an early stage);
do not delay and consult a doctor if any alarming symptoms appear on the part of the digestive system.

What is the life expectancy for small intestine cancer?

The favorable outcome of the disease directly depends on the stage at which the diagnosis was made, as well as on the location of the tumor in the intestine.

If the tumor is located regionally and does not have metastases, then after the operation the number of survivors for 5 years is 40-50%. Each subsequent stage reduces the percentage of positive outcomes in patients by 15 - 20%.

Small intestine cancer: signs and symptoms, diagnosis of the disease.

Small intestine cancer - signs and symptoms. Cancer diagnosis

According to statistics, small intestine cancer is less common than other types of malignant neoplasms of the gastrointestinal tract. Most people suffering from this disease are men over 60 years of age. In women, tumors located in this part of the intestine are diagnosed much less frequently.

What is small intestine cancer

A malignant tumor of the small intestine is considered one of the dangerous types of cancer due to extremely unfavorable prognosis for recovery and even a five-year survival. It is distinguished from others by the location of the tumor - it is located in one of the three sections of the small intestine:

in the ileum;
in the duodenum;
in the small intestine.

The largest proportion of tumors in this part of the intestine is due to duodenal cancer (about more than half of all cases). A little less often, jejunal cancer is diagnosed (about a third of all cases). The rarest type of small intestine cancer is ileum cancer.

In the total number of oncological diseases of the digestive tract, small intestine cancer, the symptoms of which will be discussed below, accounts for no more than 4% of cases.

Why does small intestine cancer occur?

The exact causes of oncological formations in the small intestine have not yet been clarified. However, reliable data confirm that this disease in most patients develops against the background of chronic pathologies of the gastrointestinal tract, as well as inflammatory processes occurring in various parts of the intestine. Experts suggest that small intestine cancer may occur due to the following ailments:

duodenitis;
colitis;
enteritis;
peptic ulcer;
Crohn's disease;
celiac disease;
Peutz-Jeghers syndrome;
benign formations in the intestine;
genetic pathologies;
malignant neoplasms of other internal organs.

The risk of getting a diagnosis increases with bad habits, malnutrition (when eating red meat, spicy, fatty and smoked foods and not having enough vegetables and fruits in the menu - sources of dietary fiber). Radioactive radiation can also provoke the transformation of cells into cancer cells.

Types of small intestine cancer

To classify the oncology of the small intestine, several signs inherent in tumors are used:

The nature of the growth of cancer cells.
Cellular structure of a cancerous tumor.

According to the nature of growth, malignant tumors are divided into exophytic and endophytic. Both one and the other type of oncology has a number of features:

On closer inspection, exophytic small bowel cancer, with signs and symptoms that are diagnosed and treated differently from endophytic, is a tumor that grows towards the inside of the intestine. Outwardly, they resemble mushrooms (with or without a stalk), plaques or polyps, and have well-defined borders and a bumpy surface. This form most often causes intestinal obstruction.
Endophytic cancer of the small intestine is a tumor without a well-defined border, and looks like a blurry formation. A tumor of this type penetrates into all layers of the intestine through the lymphatic network, and most often causes intestinal perforation and profuse bleeding.

On the basis of the structure of cells, small intestine cancer is divided into the following types:

adenocarcinoma - formations localized on the glandular tissues in the area of the duodenal papilla of the duodenum 12 (in other parts of the small intestine, this type of tumor is very rare);
carcinoid - tumors formed from epithelial tissues, and, in addition to the ileum, can occur in other parts of the small and large intestines;
lymphoma - the rarest type of tumor of the small intestine, which is represented by lymphogranulomatosis and a pathology known as Hodgkin's disease;
leiomysarcoma - tumors that grow to large sizes, which are easily palpated through the abdominal wall and often lead to perforation of the intestines.

Stages of small bowel cancer

Cancer of the small intestine, as well as other parts of it, goes through 4 stages in its development:

The first stage - the diameter of the tumor is less than 20 mm. Symptoms are absent or very mild. The body of the tumor is localized on the wall of the small intestine, the process of metastasis is absent.
The second stage - the tumor increases in size slightly. Symptoms are more pronounced due to the fact that the neoplasm grows into adjacent tissues and / or protrudes into the intestinal lumen. metastases are absent.
The third stage - the formation greatly increases in size and begins to metastasize to the lymph nodes located in close proximity to the tumor. The symptoms are severe.
The fourth stage - the tumor actively grows into neighboring organs, and also gives numerous metastases in the liver, pancreas, genitourinary system, and lungs. Symptoms become extremely severe.

Symptoms of small intestine cancer

It is very difficult at first to recognize small intestine cancer, the symptoms of which vary depending on the stage of the disease, because this type of disease is characterized by a complete absence of symptoms in the initial stages of the development of the pathological process. Significant signs appear only when the tumor leads to the appearance of ulcers or narrows the intestinal lumen.

Symptoms of early stage cancer:

nausea and belching;
diarrhea or constipation;
heaviness in the stomach;
bloating;
spasmodic abdominal pain.

As the tumor grows, the clinical picture expands, and difficulties with emptying due to false urge to defecate and / or partial or complete intestinal obstruction, intestinal bleeding and severe abdominal pain are added to the voiced symptoms.

Along with this, patients have a number of common symptoms:

growing weakness;
fatigue and general ailments;
loss of appetite or an aversion to food;
sudden weight loss;
anemia and resulting pallor of the skin and mucous membranes;
dizziness;
persistent increase in body temperature to subfebrile values.

Diagnosis of cancer of the small intestine

The most informative methods by which small intestine cancer can be detected are signs and symptoms, diagnostics using modern technologies. The first ones make it possible to suspect oncology and suggest the location of the tumor. Diagnostics using special equipment helps to reliably locate a malignant tumor, determine its type and structure, degree of development, and much more.

The most informative methods are:

screening test for intestinal cancer (feces for occult blood - Colon View immunochemical test) helps to detect oncology at an early stage, since with cancer of the small intestine, clearly expressed blood in the feces appears only with heavy bleeding, but most often bleeding is in a small amount, invisible eye, so the analysis of occult blood in the feces, allows you to suspect the disease;
fibrogastroduodenoscopy;
contrast fluoroscopy;
irrigoscopy;
colonoscopy;
histological examination of tumor samples;
Ultrasound of the abdominal cavity;
MCT of the abdomen and others (it is better to write simply CT of the abdomen)

A number of additional laboratory tests of blood and urine are also carried out to determine specific antigens, indican and tumor markers in the body.

Small bowel cancer treatment

The most effective treatment for small bowel cancer is surgical excision of the tumor. During the procedure, the affected parts of the intestine and other organs (in whole or in part) can be removed - the gallbladder, pancreas, part of the stomach.

Additionally, chemotherapy may be used. In some cases, this method plays a leading role (when the tumor is inoperable). In addition, the treatment of small intestine cancer can be carried out with the use of radiation therapy.

In the postoperative period, the patient is prescribed a combined drug treatment and chemotherapy for the final elimination of cancer cells. In most cases, recovery or stable remission requires several such courses.

Prevention of small intestine cancer

It is impossible to reduce the risk of small intestine cancer to an absolute minimum, but there are a number of preventive measures that help avoid the formation of tumors in the intestine:

Regularly undergo preventive examinations in a specialized clinic.
Adhere to the principles of a healthy lifestyle and nutrition.
In time and to the end to treat diseases of the gastrointestinal tract.
Annual fecal occult blood test (Colon View test, which can reliably detect occult blood in the stool and detect bowel cancer at an early stage).
Seek medical attention if you experience any disturbing symptoms from the digestive system.

You can complete the last step right now. At the bottom of the article there is a form for contacting our specialists - gastroenterologists and proctologists. They are available to answer any questions you may have about the symptoms and manifestations of small bowel cancer. To do this, just fill out the appropriate form and indicate your email address.

Cancer of the ileum is rare as an independent disease. As a rule, we are talking about metastases. Most often, malignant tumors are represented by adenocarcinoma. There may also be lymphomas and sarcomas.

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Symptoms of ileum cancer

Clinical manifestations of cancer develop gradually. The first symptoms are dyspeptic phenomena: nausea, vomiting, dysmotility and severe spastic colic. The result is a decrease in appetite (aversion to food), and a rapid decrease in body weight due to intoxication.

With multiple tumors, intestinal obstruction may occur, characterized by abdominal pain, vomiting, first gastric contents, and then intestinal contents, bloating, dry skin and dehydration. In sarcomas, intestinal bleeding is often observed. With the growth of the tumor, it can compress neighboring organs, which can be manifested by the development of pancreatitis, ascites, and intestinal ischemia.

Diagnosis of cancer of the ileum

endoscopy with biopsy;
fluoroscopy, MRI or CT scan with a contrast agent;
laparoscopic endoscopy;
For the diagnosis of tumors of the terminal ileum, colonoscopy and barium enema can also be informative;
Ultrasound of the OBP is also performed.

Treatment of the disease

The approaches are standard - the tumor is removed, after which the remaining tumor cells are “polished” with chemotherapy.

Treatment of ileum cancer is usually surgical, that is, removal of the tumor. For inoperable tumors, chemotherapy is used with drugs that suppress the growth and further development of malignant cells.

Pathology of the small intestine is an oncological disease that is formed in the digestive tract. Most often, the tumor grows from particles of the epithelium. Gradually, it fills the intestine.

The disease is rarely diagnosed. According to various sources, it occurs in 3-16% of cases of oncology of the digestive system. The tumor metastasizes through the lymphatic system, affecting other organs.

Most often, pathology is detected in men over 60 years of age. It is dangerous with an asymptomatic course in the early stages and a poor prognosis for survival in the latter.

The small intestine is part of the digestive tract. The section between the stomach and the large intestine is located. The organ has a tubular shape, its length is 2-4 m.

The small intestine is made up of:

duodenum- shaped like the letter "C";
jejunum- consists of loops that are freely placed in the peritoneum;
ileum- has thick walls, a large number of blood vessels.

It takes 4 hours for the food mass to pass through the entire organ.

secretory- the release of juice, which breaks down the chyme (food mass) into amino acids, monosaccharides and other elements;
digestive- digests food, breaking it down and absorbing it by all departments;
endocrine- individual cells synthesize peptide hormones;
motor- intestinal muscles move chyme, mix it with gastric juice, divide it into parts;
suction- The mucous membrane absorbs elements of chyme, drugs and supplies vitamins, salts, etc. to other organs through blood vessels and lymph.

To better understand how the digestive process occurs, it is recommended to watch the following video:

Causes

The exact causes of the appearance and development of oncology of the small intestine have not been established. But most often the disease is diagnosed in patients with obvious chronic pathologies of the gastrointestinal tract. In half of the cases, tumors originate in the duodenum. This is due to the fact that the small intestine is the first to meet aggressive substances coming from the stomach.

Adenomatous polyps- formed in the mucous membrane of the body. They can appear accidentally or be a hereditary disease. Polyps are able to degenerate into malignant neoplasms.
Chemical carcinogens- come with excessively fried food, alcohol. They injure the intestines, as a result of which healthy cells begin to mutate.
benign tumors- without timely treatment, they can develop into oncological formations.
Prolonged development of chronic gastrointestinal processes- Ulcerative formations, Crohn's disease, diverticulitis and other similar diseases. Against the background of inflammatory processes, multiple wounds and hernias are formed. If left untreated, they can become cancerous.

Kinds

Depending on the growth of a malignant tumor, two types of cancer are distinguished:

exophytic- grows along the lumen of the intestines, and then leads to obstruction. The tumor has clearly defined borders. In appearance, it is similar to polyps.
Endophytic- is highly malignant. The tumor has no visible borders, it penetrates into other organs through the lymphatic vessels and plexuses. The oncological process leads to perforation of the small intestine and subsequent bleeding.

In small intestine cancer, various cells can be affected. It depends on the type of tumor:

Adenocarcinoma- develops from glandular epithelium particles. Normally, the cells produce mucus. Cancer formations have a different shape and size, a fleecy surface.
Carcinoid- develops most often. Formed in any part of the intestine. It differs in the formation of multiple formations on a layer of squamous epithelium.
Lymphoma- the oncological process affects the particles of the lymphatic system. Pathology quickly spreads throughout the body. It is extremely rare.
Leiomyosarcoma- differs in the large size of the tumor, its diameter is more than 5 cm. It can be felt through the abdominal wall. Neoplasm creates intestinal obstruction.

Metastasis

The tumor spreads its particles throughout the body with the help of the lymphatic system. Neighboring lymph nodes are among the first to undergo metastasis:

mesenteric;
retroperitoneal.

Both parts of the intestine and distant organs can suffer from it:

liver;
stuffing box;
bones of the whole organism;
one or both lungs;
dura mater.

A malignant formation is able to grow together with the nearest organs, forming an impressive size inactive lump. It is quite difficult to extract such a conglomerate, since the formation of fistulas is high.

stages

Depending on the condition of the tumor, There are 4 stages of the oncological process in the small intestine:

Pathology is concentrated in the intestinal lumen, does not go beyond its walls.
It goes beyond the walls of the organ, the stage of its growth throughout the body begins, but there is no metastasis yet.
Metastases are formed, but they affect only neighboring tissues, such as lymph nodes located near the intestines.
Secondary tumors formed in distant organs and tissues.

Symptoms

The disease begins to appear gradually. In the early stages, it does not have a pronounced clinical picture. Because of this, patients turn to a specialist in the later stages, when the pathology grows into the intestinal tissue and spreads metastases to neighboring organs.

Main symptoms:

dyspeptic disorders- are manifested by pain in the intestines, vomiting, bloating of the peritoneum, nausea;
weight loss- associated with malnutrition, rapid progression of the oncological process;
intestinal bleeding- occur with endophyd form;
intestinal obstruction- occurs with the development of large tumors, is expressed by vomiting and dehydration, leads to death;
frequent loose stools with mucus- associated with intestinal obstruction;
jaundice, pancreatitis, ascites- may develop due to compression of neighboring organs by the tumor;
peritonitis- occurs when the wall of the small intestine ruptures due to an overgrown tumor.

Diagnostics

Early diagnosis will allow to identify the pathology in the initial stages. This is of great importance for the treatment of small intestine cancer.

Basic diagnostic methods:

Oncomarker CA 242- the antigen is detected at the onset of the oncological process in the digestive tract. The development of the disease is indicated by an indicator above 30 IU / ml.
Oncomarker CEA- in adults it occurs in very low concentrations (0-5 ng / ml). The test allows you to determine the size of the neoplasm in the small intestine.
Oncomarker SA 19-9- the antigen can be found in the cells of various organs, saliva, secretions and other human fluids. Because of this, the test cannot determine the exact location of the tumor. An indicator above 40 IU / ml indicates a malignant process.
Fecal occult blood test- helps to identify asymptomatic bleeding from the gastrointestinal tract, including the small intestine.
Fibrogastroduodenoscopy- allows you to explore the duodenum, the state of its mucosa.
Contrast fluoroscopy- evaluates the condition of the small intestine. As a contrast, barium sulfate is most often used, which the patient drinks during the procedure.
Irrigoscopy- the patient needs to thoroughly clean the intestines and drink a radiopaque substance. The specialist examines the body and takes pictures.
Colonoscopy- is carried out by a special device consisting of a tourniquet and an optical system. Requires bowel cleansing.
Endoscopy- an ultrasound transducer is inserted into the rectum. The method allows you to determine the nature of education. It is characterized by the absence of pain.

Learn more about what a colonoscopy is:

Treatment

Surgery is the most effective treatment for small bowel cancer.

The main methods of treatment:

Duodenectomy- a surgical procedure, as a result of which the duodenum is excised and continuous patency of the gastrointestinal tract is restored.
Ectomy of the gallbladder and pancreas- removal is carried out surgically, can be complete or partial. The removed tissues are sent for histology to determine the further treatment tactics.
Distal gastrectomy- a surgical intervention in which the distal part of the organ is removed. The operation consists of several stages: assessment of the degree of changes, determination of the scope of work, removal of the selected area, formation of the anastomosis.
Ectomy of the right half of the large intestine- the method involves dissection of the abdominal cavity (laparotomy), mobilization of the right side of the organ, intersection of the large and small intestines, formation of an anastomosis, layer-by-layer suturing of the peritoneum.
Chemotherapy– therapy consists of several cycles, each of which lasts 1-2 months. The patient during treatment does not stop the usual way of life.
Radiation therapy- the course is held for 1-2 months. The procedure is painless, but has side effects that disappear after stopping therapy.

Forecast

The malignant process in the small intestine with timely treatment can be completely stopped. The success of the prognosis depends on the stage of the disease:

in the first two stages 35-40% of patients live more than 5 years;
at the last stage recovery is impossible, the quality of life improves, in 5% of patients it is extended by 5 years.

If left untreated, death can occur due to intestinal obstruction, peritonitis, failure of damaged organs.

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Oncology or cancer of the small intestine is characterized by the appearance of a malignant tumor lesion of certain parts of the small intestine (jejunum, ileum or duodenum). The main manifestations of the disease are dyspeptic disorders (flatulence, nausea, abdominal cramps, vomiting, etc.).

A late visit to the doctor threatens with a sharp weight loss against the background of gastric disorders, as well as intestinal stasis and, as a result, intestinal bleeding.

Statistics on the location of the cancerous process of tumor development in the small intestine is as follows:

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duodenal oncology accounts for approximately 48% of diseased cases;
oncology of the jejunum was detected in 30% of the disease;
oncology of the ileum accounts for 20% of cases.

Most often, oncology of the small intestine occurs in the body of older men aged about 60 years and older. As a rule, men are more prone to developing this disease than women, especially in the countries of Central Asia.

Reasons for the development of the disease

The mass number of cases of small intestine cancer occurs in the presence of obvious chronic diseases of the gastrointestinal tract, as well as against the background of inflammatory and enzymatic processes localized in the small intestine.

Predisposing factors may be the following diseases of the gastrointestinal tract:

duodenitis;
peptic ulcer;
Crohn's disease;
enteritis;
diverticulitis;
colitis;
celiac disease;
genetic abnormalities;
benign intestinal processes;
malignant tumor processes of other organs, metastasizing throughout the body.

The prevailing high percentage of damage to the initial section of the small intestine is determined by the irritating effect of bile and food blastimogens coming from outside products, as well as gastric juice on the above section of the small intestine.

It was found that cases of diffuse polyposis of a different pathology can be considered a contributing factor to the formation of small intestine cancer.

There is a high probability of predominance of small intestine cancer in chronic smokers, people with alcohol and drug addictions, as well as in people exposed to radioactive components.

Fans of canned foods, well-done foods, and foods with a predominance of animal fats also fall into the category of people with an increased risk of developing small intestine cancer.

Classification

According to histology, malignant neoplasms of the small intestine are represented by the following types:

By histological type

Adenocarcinoma- is a cancer that develops from the glandular tissue of the body. A rare form of oncology of the small intestine, which is formed within the major duodenal papilla. Such a tumor is usually ulcerated and has a fleecy surface.

Carcinoid- in structure it resembles the epithelial form of small intestine cancer, which is most common, because it is localized in any part of the intestine. The most common localization is in the appendix (vermiform appendix), less in the ileum and even less often in the rectum.

Lymphoma- a relatively rare type of tumor formation in the small intestine. According to statistics, lymphoma is formed only in 18% of cases of small intestine cancer. In this group of the tumor-like process, lymphosarcomas and lymphogranulomatosis or Hodgkin's disease are distinguished.

Leiomyosarcoma- a fairly large tumor, which is more than 5 centimeters in diameter. This type of tumor-like formation is easily palpated through the abdominal wall and is the main cause of intestinal obstruction, then perforation of the intestinal wall and bleeding.

Types of tumor growth

Depending on the characteristic development of the existing neoplasm, small intestine cancer is divided into two types: exophytic and endophytic.

Exophytic character the tumor grows into the intestinal lumen, thereby causing stasis of a certain section of the small intestine, and further flowing into intestinal obstruction. In addition, an exophytic tumor is a formation with well-defined structured boundaries, having an external resemblance to polyps, fungi or plaques. In the case of ulceration of such a tumor, it becomes similar to a saucer in the central part.

The most dangerous and malignant is the endophytic (infiltrative) tumor.

This type of tumor growth is characterized by the penetration of the tumor into other organs without any visible borders. The tumor, as it were, spreads along the walls, flowing over the membranes of the organs and penetrating into other areas of the body through the lymphatic vessels and plexuses.

This type of tumor does not grow into the lumen of the organ and does not have certain pronounced boundaries. Endophytic type of tumor growth is accompanied by perforation of the small intestine and subsequent bleeding.

The worldwide systematization of the statistics of tumor formations in the small intestine according to the TNM classification looks like this:

Tis - pre-invasive oncology;
T1 - growth of cancer in the submucosal layer of the intestinal wall;
T2 - tumor growth in the muscle tissue layer of the small intestine;
TK - penetration of the tumor into the subserous layer of the walls of the small intestine or the area located behind the peritoneum with a length of no more than 2 centimeters;
T4 - ingrowth of the formation in the peritoneum, as well as other parts of the intestine more than 2 cm long, the organs surrounding the intestine;
M0 and N0 - the tumor develops without metastasis;
N1 - metastasis to the surrounding lymph nodes (mesentery, gastric region, pancreatoduodenal region and liver);
detection of cancer carriers in the omentum, kidneys, peritoneum, adrenal glands, in the liver, lungs and bone tissue.

Diagnostics

The system of diagnostic procedures for the manifestation of oncological disease of the small intestine has its own characteristics and uniqueness.

In order to identify and recognize a duodenal tumor, it is necessary to perform a gastroduodenoscopy procedure, as well as fluoroscopy using a contrast agent. Diagnosis of oncology of the ileum consists in the use of irrigoscopy and colonoscopy methods.

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The main role in determining the obstacles in the form of narrowing in the passage of the small intestine, as well as stenosis and expansion of the intestines, is played by radiography using the passage of barium.

Often, a specific diagnostic approach may begin with a selective angiography procedure of the intestinal cavity.

Each of the endoscopic methods used for the diagnosis of a disease represents the possibility of taking the necessary biopsy to obtain the morphological composition of the tumor and a clear diagnosis and, as a result, the appropriate treatment of cancer. Based on the result of the biopsy, it is possible to determine the type of tumor growth, the type and degree of malignancy of the formation.

To diagnose and detect metastasis, an ultrasound examination (ultrasound) is performed:

pancreas;
liver;
adrenal glands;
kidneys.

The following research is also underway:

multispiral CT of the abdominal cavity;
bone scintigraphy;
chest x-ray;
diagnostic laparoscopy;

It is necessary to clearly contrast the oncology of the small intestine with the following diseases:

inflammatory, but benign processes in the small intestine;
scrofuloderma of the small intestine;
enteritis (Crohn's disease);
tumors localized in the retroperitoneal regions;
abruptly arising obstruction of the mesenteric vessels;
violation in the correct physiological position of the kidneys;
tumors of the ovaries and uterus in women;
congenital stasis of the small intestine;
colon oncology.

The colonoscopy method is able to detect the initial stages of tumor growth in the intestine or implicit changes in the internal structure of the intestinal wall. And with the help of chromoscopy, you can examine the inner lining of the small intestine and diagnose neoplasms with their subsequent removal.

Small bowel cancer treatment

Depending on whether surgical intervention is possible at this stage of cancer of the small intestine, it is highly effective to perform an extensive ectomy of the entire cancerous area of the small intestine, together with the surrounding mesentery and lymph nodes.

It is possible to radically remove the tumor, including healthy tissue, because the length of the small intestine is sufficient for such an extensive operation to remove tissue.

In addition, the removed site is restored artificially as a result of the imposition of enteroenteroanastamosis (surgical articulation between intestinal loops) or enterocoloanastomosis (connection between the loops of the large and small intestines).

In the case of duodenal cancer, therapy consists of duodenectomy with additional distal gastrectomy and pancreatic ectomy.

If the stage of small bowel cancer is started and extensive resection is unacceptable, then a bypass anastomosis is surgically implanted along a healthy area of the small intestine.

In addition to surgery, chemotherapy is also used. By the way, often with inoperable stages of cancer, the only way to alleviate the pain of the patient is the use of chemotherapy. Such treatment helps to slow down the growth of the neoplasm.

According to statistics, in 2/3 of cases of oncology of the small intestine resort to surgical intervention. A radical method of treatment helps to reduce symptoms and increase life expectancy. Often an ectomy is just a way to alleviate the suffering of the patient.

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Forecast

The prognosis as a whole depends on the timely visit to the oncologist and the stage of the developing cancer. Early diagnosis of the tumor and its removal can give the chance of a complete cure of the patient from cancer. It is much easier to perform an ectomy of an uncomplicated tumor than to perform operations on advanced stages of cancer.

It is important to undergo preventive examinations annually for the presence of neoplasms in the body, especially after 40 years. According to statistics, small intestine cancer is one of the curable types of colon cancer. Due to the fact that the small intestine is poorly supplied with blood, therefore, metastasis develops very slowly and infected blood enters the body in negligible amounts.

Therefore, the prognosis for patients with small bowel cancer is very good in many cases.

This is one of the few forms of cancer that, with timely treatment, contributes to a full recovery.

Many patients, after curing bowel cancer, continue to live a full life and only remember their illness at annual examinations.

Prevention

Under the condition of early surgical intervention, the development of the pathological process of small intestine cancer stops and the effect of the operation is fixed by ongoing chemotherapy.

A number of simple rules that help prevent the occurrence of small intestine cancer:

maintaining an active lifestyle, regardless of age;
the use of vegetable coarse fiber is more than animal fats;
conducting regular preventive examinations;
if you suspect a disease, immediately contact a specialist.

Take care of your health, conduct a complete examination of your body in time.