title: Most small bowel cancers are revealed by a complication.
abstract: OBJECTIVE
  To characterize the pattern of primary small bowel cancers in a tertiary East-European hospital.
  
  
  METHODS
  A retrospective study of patients with small bowel cancers admitted to a tertiary emergency center, over the past 15 years.
  
  
  RESULTS
  There were 57 patients with small bowel cancer, representing 0.039% of admissions and 0.059% of laparotomies. There were 37 (64.9%) men, mean age of 58 years; and 72 years for females. Out of 57 patients, 48 (84.2%) were admitted due to an emergency situation: obstruction in 21 (38.9%), perforation in 17 (31.5%), upper gastrointestinal bleeding in 8 (14.8%), and lower gastrointestinal bleeding in 2 (3.7%). There were 10 (17.5%) duodenal tumors, 21 (36.8%) jejunal tumors and 26 (45.6%) ileal tumors. The most frequent neoplasms were gastrointestinal stromal tumor in 24 patients (42.1%), adenocarcinoma in 19 (33.3%), lymphoma in 8 (14%), and carcinoids in 2 (3.5%). The prevalence of duodenal adenocarcinoma was 14.55 times greater than that of the small bowel, and the prevalence of duodenal stromal tumors was 1.818 time greater than that of the small bowel. Obstruction was the complication in adenocarcinoma in 57.9% of cases, and perforation was the major local complication (47.8%) in stromal tumors.
  
  
  CONCLUSIONS
  Primary small bowel cancers are usually diagnosed at advanced stages, and revealed by a local complication of the tumor. Their surgical management in emergency setting is associated to significant morbidity and mortality rates.
authors.affiliation: Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Ionut
authors.initials: I
authors.lastname: Negoi
authors.affiliation: Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Sorin
authors.initials: S
authors.lastname: Paun
authors.affiliation: Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Sorin
authors.initials: S
authors.lastname: Hostiuc
authors.affiliation: Emergency Hospital of Bucharest, Bucharest, Romania.
authors.forename: Bodgan
authors.initials: B
authors.lastname: Stoica
authors.affiliation: Emergency Hospital of Bucharest, Bucharest, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Tanase
authors.affiliation: Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Ruxandra Irina
authors.initials: RI
authors.lastname: Negoi
authors.affiliation: Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Mircea
authors.initials: M
authors.lastname: Beuran
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000150:complications* / Q000401:mortality / Q000601:surgery; D004379:Duodenal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005061:Europe, Eastern; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000401:mortality / Q000601:surgery; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery; D033162:Incidental Findings; D007414:Intestinal Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology*; D007416:Intestinal Perforation / Q000209:etiology*; D007580:Jejunal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery; D008223:Lymphoma / Q000150:complications / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D015995:Prevalence; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult