Abstract
Primary cancer of the small intestine is a relatively rare condition. It is usually difficult to make a precise diagnosis preoperatively because there is no specific symptom for this illness. Recently we have operated on three adult male patients with primary small intestinal adenocarcinoma, located at the proximal segment of the jejunum near the Treiz's ligament, the Meckel's diverticulum and the terminal ileum near the ileo-caecal valve respectively. All three patients presented abdominal distention, abdominal pain and vomiting, suggesting bowel obstruction. Preoperative X ray study using contrast medium revealed “apple-core” lesion of the jejunum and the ileum except the Meckel's diverticulum. In the case of jejunal cancer, the fiberscope was of use to confirm the diagnosis. Because of delayed onset of symptoms as well as difficulty in establishing the diagnosis, small intestinal cancer is, in general, found in an advanced stage at laparotomy. To detect small intestinal tumors in an earlier stage, we should actively conduct a survey of the small bowel for the patients who have abdominal pain, distention and vomiting, especially when no stenotic lesion is detected by the studies of both upper gastro-intestinal and colorectal tract.
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