Gastrointestinal Hemorrhage due to Carcinoid Tumors of the Small Intestine

Kreis, David J.

doi:10.1001/jama.1986.03370020080033

Cited by 9 publications

(2 citation statements)

References 7 publications

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“…Depending on the prominent symptoms, the work-up series differs. In the case of gastrointestinal bleeding, the used imaging modalities are endoscopy of the gastrointestinal tract, red blood scintigraphy and computed tomography[ 19 ]. In the case of intestinal obstruction, the primary used imaging modalities are computed tomography and magnetic resonance imaging.…”

Section: Discussionmentioning

confidence: 99%

Midgut neuroendocrine tumor presenting with acute intestinal ischemia

Mantzoros¹,

Savvala²,

Ioannidis³

et al. 2017

WJG

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Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors, commonly called carcinoids, account for about 2/3 of all neuroendocrine tumors, they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms, which usually leads to a delayed diagnosis. Imaging modalities can aid diagnosis and surgery remains the mainstay of treatment. We present a case of a jejunal neuroendocrine tumor that caused nonspecific symptoms for about 1 year before manifesting with acute mesenteric ischemia. Abdominal X-rays revealed pneumatosis intestinalis and an abdominal ultrasound and computed tomography confirmed the diagnosis. The patient was submitted to segmental enterectomy. Histopathological study demonstrated a neuroendocrine tumor with perineural and arterial infiltration and lymph node metastasis. The postoperative course was uneventful and the patient denied any adjuvant treatment.

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Section: Discussionmentioning

confidence: 99%

Midgut neuroendocrine tumor presenting with acute intestinal ischemia

Mantzoros¹,

Savvala²,

Ioannidis³

et al. 2017

WJG

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“…Bleeding occurs from mucosal ulceration at the site of the tumour [6] and not due to peptic ulcerations in the stomach and duodenum. In the present case there was only a tiny ulcer on the mucosa at the site of the tumour.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Peptic Ulcer due to Carcinoid Tumour of Jejunum

Bhattacharyya¹

2011

Indian J Surg

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Carcinoid Tumours are classified as Neuroendocrine tumours. Commonly known ulcerogenic neuroendocrine tumour is Gastrinoma of the Pancreas and Duodenum.It secretes hormone Gastrin which causes hyperplasia of the gastric parietal cells with excessive secretion of hydrochloric acid resulting in multiple ulcerations in the stomach, duodenum and upper jejunum. Carcinoid tumours is not known to cause peptic ulceration. Keywords Peptic ulcer . Carcinoid tumour Case ReportA 17 year old male patient was admitted to the Department of Surgery in March 1997 with signs and symptoms of gastric outlet obstruction. In the preceding 2 years he was admitted to the same hospital 4 times with pain abdomen, vomiting, and malaena on 2 occasions. On each occasion upper G.I.Endoscopy showed ulcers in the stomach, 1st and 2nd part of Duodenum. He was treated conservatively with H2 antagonist, protein pump inhibitors, sucralfate with relief of symptoms. When presented with malaena and low haemoglobin blood transfusion was given.On admission he was haemodynamically stable. Routine blood tests including liver function tests, B.T, C.T, prothombin time and serum gastrin were done. Hb% was 9 Gm/dl and serum Gastrin 160 pg/L, twice the normal value. Rest of the tests were within normal limits. Upper G.I.Endoscopy and Barium studies confirmed gastric outlet obstruction and he was operated. As on earlier endoscopic examinations, this time also ulcers were found to extend up to 2nd part of Duodenum.On laparotomy, tail of pancreas had two tiny nodules and was removed. There were about a dozen fleshy enlarged lymph nodes in the mesentery, largest one about 3 cms. A hard nodule of about 1.5 cm was found on the anti-mesenteric border of the jejumun about 15 cm from the D-J flexure. The jejunal nodule and two enlarged lymph nodes were removed for histopathological examination. Truncal vagotomy and posterior gastrojejunostomy was done, utilizing the enterotomy in the jejunum created while removing the jejunal nodule. Rest of the abdomen including liver was normal. The patient had an uneventful recovery.Histopathological examinations of the Jejunal nodule showed picture of carcinoid tumour, mainly in the submucosa infiltrating the muscle and ulcerating the mucosa at one site only. Lymph nodes showed metastatic deposits; no pathology was found in the resected tail of the pancreas . Urinary 5HIAA was within normal limits.MEN Syndrome I was excluded from a normal skull X-ray.He was put on oral PPI and remained symptom free. He experienced occasional mild reflux symptoms well controlled by added antacid preparations. Check upper G.I. Endoscopy after 2 and 4 months showed complete healing of ulcers and healthy G-J stoma and PPI was stopped. He remained asymptomatic on regular follow up.After 11 months USG of abdomen showed doubtful lymphadenopathy. CT confirmed retroperitoneal lymphadenopathy and a doubtful jejunal mass. Second laparotomy was carried out in February,1998. Appendix was removed and multiple biopsies taken from thickened jejunal wall,

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