Small Bowel Carcinoid Mitsuyuki Murano 1 , Ken Kawakami 1 , Hiroaki Yamauchi 2 , Toshihiko Okada 2 , Yosuke Abe 2 , Naoko Murano 2 , Hiroshi Akutagawa 3 , Yutaro Egashira 3 , Ichiro Hirata 4 , Kazuhide Higuchi 1 1The Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan 2Department of Gastroenterology, Ijinkai Takeda General Hospital, Kyoto, Japan 3The First Department of Pathology, Osaka Medical College, Takatsuki, Japan 4Department of Gastroenterology, Fujita Health University, Toyoake, Japan Keyword: 小腸カルチノイド , 画像診断 , 小腸内視鏡 pp.547-552
Published Date 2008/4/24
DOI https://doi.org/10.11477/mf.1403101328
  • Abstract
  • Look Inside
  • Reference
  • Cited by

 Small bowel carcinoid is a rare disease in Japan, compared to Western countries. The preoperative diagnosis of small bowel carcinoid has been difficult so far, because standard imaging techniques, such as colonoscopy and small-bowel barium contrast studies, rarely identify the primary small bowel carcinoid. Because of this, many cases were diagnosed from major symptoms or by resected specimens of small bowel tumors.

 Recently, the double-balloon small intestine enteroscope and the capsule endoscope have been introduced and have markedly advanced the diagnosis of small bowel disease. Therefore, it is necessary to recognize the clinical characteristics of small bowel carcinoid accurately. In this article, we described specific clinical features of small bowel carcinoids.

 In general, small bowel carcinoids can be characterized as having slow or indolent growth. They are often located very close to the ileocecal valve. Accordingly, careful examination of the ileum by colonoscopy has been useful in the detection of primary carcinoid tumors in the ileum. Tumor size is an unreliable predictor of metastatic disease. The metastases, to the lymph node or liver, have been reported even from tumors measuring less than 10 mm in diameter. Moreover, surgical management of small bowel carcinoids and also synchronous tumors requires wide resection together with complete resection of the supporting mesentery and lymph nodes, because small bowel carcinoid mostly develops multicentrically.

 In the future, pre-operative double-balloon enteroscopy and capsule endoscopy will be useful for investigating other lesions in the small bowel.

Copyright © 2008, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院