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Benign tumors of a small bowel

Tumors of a small bowel belong to very rare and it is difficult for the diagnosed diseases.
High-quality new growths (leiomyomas, lipomas, adenomas, a hemangioma and a heterotopy) are more often localized in an ileal gut, seldom happen multiple and grow as in a gleam, and outside. In the latter case they can reach the big sizes.

The clinical picture of high-quality educations in most cases entirely depends on their sizes and possible complications (an ulceration, bleeding, perforation). Intestinal impassability is usually preceded by an uncertain abdominal pain, locks for a long time. The hypochromia anemia which is a consequence of the concealed hemorrhage (for example, in case of a hemangioma), and also an endometriozny heterotopy can sometimes be the only symptom of a tumor.

The abenteric symptomatology is characteristic of some tumors. So, polyposes of intestines can be followed by emergence of sites of hyperpegmentation on skin and mucous membranes (Peytts's syndrome — Dzhigersa) or early baldness, an atrophy of nail plates (Cronkite's syndrome — Canada). At a carcinoid tumor of the small bowel producing serotonin, a histamine and bradykinin there are sudden attacks of asthma with a sharp dermahemia, heartbeat, a colicy pain in a stomach and a diarrhea. At a dihundred-pyrobathing pancreas hyper dysinsulinism symptoms in the form of attacks of hunger, weakness, decrease in level of glucose in blood etc. are possible.

The diagnosis presents great difficulties. Palpations are available only big tumors with exophytic growth which are found exclusively seldom. The main diagnostic method — radiological at which at a stage of partial intestinal obstruction it is possible to find horizontal levels and defect of filling in an intestinal loop. Carrying out this research at a stage of the expressed intestinal impassability is fraught with dangers because of possible development of obturation. Possibilities of an endoscopic method are limited to distal department of duodenal and ileal guts though by means of a special enteroskop also earlier unavailable sites of a small bowel can be examined. For diagnosis of a hemangioma the selection mezenterikografiya by means of which the pathological vascular network in system of branches of an upper mesenteric artery comes to light is shown.
The diagnosis of carcinoid of a small bowel is confirmed by definition in urine of the increased maintenance of a metabolite of serotonin (5-hydroxyindole-acetic acid).

The differential diagnosis should be carried out with the tumors proceeding from retroperitoneal lymph nodes, a mesentery of the small bowel wandering and a dihundred-pyrobathing kidney, cysts and tumors of appendages of a uterus, a pancreas cyst.

In the course of growth the majority of benign tumors is capable to regenerate in malignant new growths. Carcinoid, adenomas and leiomyomas are especially dangerous in this respect.

The main method of treatment — surgical. All tumors of a small bowel are subject to operational treatment. Now endoscopic electrocoagulation of the polipovidny educations which are located within the zone available to this method is possible.

 
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