Neoplasms of the Small Intestine
Neoplasms of the small intestine constitute only a small percentage of the tumors found throughout the gastrointestinal tract, but they are discovered frequently enough to make the clinician “small bowel conscious”. Certainly this type of lesion should always be considered when a patient is seen with obscure intestinal symptoms or with bleeding from the bowel of undetermined origin. Ewing1 states that carcinoma of the small intestine is comparatively rare, forming about 3 per cent of all intestinal cancers. Tumors of this type constitute the majority of the small intestine neoplasms. The next most common type is that of the sarcoma group. Sarcoma may occur in any portion of the small intestine but is seen more often in the ileum. A third type of neoplasm to be considered is the carcinoid or argentaffin tumor which is also seen with greater frequency in the ileum than in the proximal portion of the small intestine. These tumors are usually small intramural growths and seldom give rise to clinical symptoms. They are seldom discovered by roentgen examination and are more apt to be seen at autopsy or as an incidental finding at operation.
Many tumors of the small intestine are not definitely diagnosed before operation because a special roentgen examination of the intestine has not been made. Instead, and with some logic, the diagnosis is made by an exclusion process following a negative roentgen examination of the stomach and colon. Considering the rarity of tumors of the small intestine, it is readily understood why. . .