Small intestine surgery
Duodenum, jejunum and ileum are parts of the small intestine.
The first part of the small intestine is duodenum which is 20-30 cm long and about 4 cm wide.
Jejunum is 2,5 m long and ileum is 3,5 m long on average.
The small intestinal mucosa is rich in blood vessels. It forms transversal, spiral or circular folds which are the biggest in the end part of the duodenum , decreasing gradually and then disappearing completely at the end of the ileum. These folds have a very significant role in digestion and food absorption because they increase the active intestine surface.
Benign tumours of the small intestine belong to rare diseases of digestive tract ( about 0,16 percent of all tumours)
and they are most often detected during the operation.
Benign tumours of the small intestine are usually localised in the ileum, they may be peduncular or sessile, solitary or multiple. The most frequent ones are adenomas, lipomas, leiomyom,etc.
The most commom symptoms are: blood in the stool, bleeding, intussusception, stenosis, malignant alterations.
Malignant intestine tumours are among the rarerest tumours of digestive organs (2% incidence).
The exact causes are not known, but there are certain risk factors like hereditary diseases such as adenomatous polyposis, inadequate diet- a lot of red meat,salty and smoked meat, alcohol intake, smoking, Crohn’s disease…
In the initial stage, there are no symptoms but as a disease progresses 90% of patients develop some of the symptoms:nausea, vomiting and intestinal obstruction.
Atypical stomach pains can also be one of the symptoms. Sometimes there is blood in the stool, anaemia,tachycardia, paleness, weakness ,etc. In patients with neglected disease it is even possible to feel the tumour.
How is the procedure carried out?
In the Atlas general hospital, diagnosis is established according to anamnesis, clinical picture, radiological examination, endoscopic examination, biopsy and histological analysis.
In complicated cases surgical treatment is necessary.
Anamnesis with a clinical picture and objective examination is enough to detect certain processes but additional examinations are also needed to be done.
Laboratory analyses can detect anaemia hyperbilirubinemia as well as the increased carcinoembryonic antigen.
Endoscopic examination is very useful for patients (capsule endoscopy) but its disadvantage is the fact that it is not possible to do biopsy during this examination.
Scanner examination is also very useful.
Final diagnosis is established according to histopathological analysis and a tissue sample obtained after the operation. During surgery, a tumor and a part of the intestine is removed.
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Dr Nemanja ZarićSpecialist in general surgery
Doc. dr sci med Dejan VeličkovićSpecialist in general surgery
Đorđe KneževićSpecialist in general surgery
Doc. dr Ebrahim KeramatollahSpecialist in general surgery
Ass. dr Ognjan SkrobićSpecialist in general surgery
Dr Ilija PejovićSpecialist in general surgery