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Small Bowel Carcinoid
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Written by Dr Sebastian Zeki
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Small Bowel Carcinoid
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Written by Dr Sebastian Zeki
Features
Carcinoid lesions infiltrate the
bowel wall and constricts
mesentery through a
desmoplastic reaction.
Small bowel carcinoids are
most commonly found in the
ileum, within 60 cm of the
ileocecal valve.
5yr survival in patients with distant metastasis is 36 %.
Small Bowel Carcinoid
Frequently malignant and diagnosed late
Age: 60s or 70s
Derived from
intraepithelial
endocrine cells
Multiple in 30%-
Patients are:
Younger
More likely to have the
carcinoid syndrome
Have a worse prognosis.
Treatments:
Endoscopic resections for duodenal carcinoid.
Resection of the involved segment+mesentery+ LN.
Palliative resection.
Clinical Features:
Vague abdominal pain- this occurs in 40 % and is possibly ischaemic due to seretonin/ mesenteric vascular
invasion.
Intermittent obstruction occurs in 25 %-due to intraluminal tumour,and mesenteric kinking due to tumour
invasion and 2ndary
desmoplastic
response.
Carcinoid syndrome in 10%.
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