adenocarcinoma of the small intestine

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The adenocarcinoma is the commonest type of malignant tumour of the small intestine. They are clustered within 25 centimetres either side of the duodenojejunal flexure; ileal carcinoma is rare except for that which is secondary to Crohn's disease.

The peak frequency of carcinoma is within the seventh decade with an equal sex distribution. The clinical presentation is one of occult bleeding and partial obstruction, or, if more proximally in the duodenum, epigastric pain, vomiting and jaundice.

Investigative measures include endoscopy with biopsy and barium studies. Treatment is by surgical resection: more proximally, a pancreaticoduodenectomy may suffice; more distally, bowel and mesenteric resection is required.

Prognosis is poor - 15-25% at 5 years - mainly due to the insidious progression of the tumour.

Last reviewed 01/2018

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