Carcinoid Tumors of the Small Intestine

Small bowel carcinoid tumors comprise approximately one third of small bowel tumors. They are most frequently located in the distal ileum and are often multicentric, occasionally appearing as dozens of lesions lining the small bowel. Patients with small bowel carcinoids generally present with abdominal pain or small bowel obstruction. Standard imaging techniques such as CT scan and small bowel barium contrast studies only rarely identify the primary tumor, making the preoperative diagnosis of small bowel carcinoid difficult. Patients frequently experience vague abdominal symptoms for several years prior to the time of diagnosis.

Small bowel resection, together with resection of the associated mesentery, is the treatment of choice for small bowel carcinoids. These tumors are frequently associated with “buckling” of the intestine due to extensive mesenteric fibrosis. Occasionally, mesenteric ischemia due to either fibrosis or to an associated mesenteric angiopathy may occur. Resection is therefore undertaken for palliative purposes, even in patients with known metastatic disease.

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