cancer of the small intestine, a neoplastic disease of the duodenum, jejunum, or ileum. Adenocarcinomas, the most common tumors, occur more frequently in the duodenum or upper jejunum and form polypoid or constricting napkin-ring growths. Lymphomas, found most often in the lower small intestine, may impair bowel motility by invading nerves and in some cases are associated with a malabsorption syndrome. Less common tumors of the small intestine are carcinoids, usually found in the ileum, and sarcomas, including Kaposi’s sarcoma, usually seen in the jejunum and ileum. A leiomyosarcoma may sometimes form a large extraluminal mass. ▪ OBSERVATIONS: Characteristics vary, depending on the kind of tumor and the site, but may include abdominal pain, vomiting, weight loss, diarrhea, intermittent bowel obstruction, GI bleeding, or a mass in the right abdomen. Diagnosis typically is made with barium radiographic examination, but results of such studies may be inconclusive until lesions are large. CT scans of the abdomen or an abdominal ultrasound are utilized to visualize bulky tumors and to evaluate metastasis. ▪ INTERVENTIONS: Surgery, including a wide resection of mesenteric lymph nodes, is typically indicated for adenocarcinomas and carcinoids. Irradiation occasionally is indicated. Chemotherapy is often useful, particularly for lymphoma. ▪ PATIENT CARE CONSIDERATIONS: The prognosis for 5-year survival is poor. Factors affecting the prognosis include tumor stage and the presence of metastases at diagnosis.
