The diagnostic and surgical challenges of small bowel disease not involving the duodenum

Abstract

BACKGROUND: Because of the lack of specific signs and symptoms, benign and malignant small bowel disease (SB) diagnoses and their treatments are very difficult. The aim of this study was to determine the challenges of diagnostic and surgical treatment of SB diseases.

MATERIAL AND METHODS: Of 51 patients, 29 (56.9%) had undergone surgery for non-malignant small bowel (NMSB) diseases, whereas 22 (43.1%) had malignant small bowel (MSB) diseases. All data were collected and compared between the two groups.

RESULTS: Patients with MSB had statistically higher levels of disease in the jejunum (50% versus 10.3%; p=0.004), while patients with NMSB had statistically higher disease levels in the ileum (89.7% versus 50%; p=0.002). Twelve (54.5 %) patients in MSB and 18 (62%) patients in NMSB had emergent laparotomy (P=0.76). There were not significant diferrences in postoperative complications (8 [36.4%] in MSB versus 4 [13.8%] in NMSB; p=0.10 and 5 [22.7%] versus 3 [10.3%]; p=0.374). Patients in the MSB group had a statistically signficant lower 5-year survival rate (p=0.038).

CONCLUSION: Overall this study showed that preoperative evaluation may not always be capable of differentiating MSB from NMSB disease. Therefore, most patients present with advanced disease stages.