Clinical profile, surgical management, outcome and follow-up of small bowel tumors.

Objectives: To study small bowel tumors with regard to 1) clinical profile; 2) Pathological classification; 3) Detection of tumors; 4) Surgical outcome; 5) Prognostic factor evaluation; & 6) Follow up. Study Design: Prospective and retrospective, hospital based. Material & Methods: a total of 40 small bowel tumors were analyzed during study period (from 1995 to 2006 onwards) – prospective/retrospective analysis. Retrospective records were collected from Department of Medical Records, SKIMS and studied. Results: Out of 40 small bowel tumors, males were 62.5%; overall mean age was 45.2 years. Most common presentation was abdominal pain (75%) followed by malena. Examination revealed abdominal mass (42.5%) as the commonest finding. Investigations carried out included CECT abdomen (60% sensitivity), CT enteroclysis (100% sensitivity), USG abdomen, EGD, barium follow and X-ray abdomen standing. Most of the tumors were malignant (82.5%); only 17.5% tumors were benign. Most common malignant tumor was adenocarcinoma (57.5%) whereas most common benign tumor was leiomyoma (5/7, 71%). Most common site was ileum (50%), for benign as well as malignant tumors. Metastasis and curative resection were prognostic factors. Mean survival was 51 months; overall survival rate was 55% and overall censored rate was 45%. Conclusions: Small bowel tumors are rare. Incidence is 0.2% of all gastrointestinal tumors; 0.1% of all surgical malignancies. Metastasis, surgical resection and type of tumor are prognostic factors