Small intestine note path

small intestine anatomy

longest section of digestive tube, 3 passages, 6 m in length, final stages of enzymatic digestion

3 passages connecting pylorus to large intestine

duodenum, jejunum, ileum

epidemiology

<5% GI tumors, benign (leiomyomas & adenomatous polyps) and malignant (adenocarcinoma proximal small bowel & carcinoid in distal bowel)

etiology

inherited disorders, FAP, Gardener’s, Peutz Jeghers, Chrohn’s

why is detection so hard

insidious nonspecific symptoms, 6-12 month symptoms before diagnosis

signs & symptoms

abdominal pain, hemorrhage, weight loss, abdominal mass

diagnostics

barium (best), upper GI series, enema, angiography, endoscopy

radiation

whole abdominal, lymphoma or carcinoid lesions

chemo

5-FU, stepoxotocin

prognosis

• adenocarcinoma - 20-30%

• sarcoma 20-50%

• resectable lymphoma 40-70%

• unresectable 25%