Small bowel cancer

Ross, and R. A. Malt, Promotion of Azoxymethane-induced colonic neoplasia by resection of the proximal small bowel. Cancer Res., 38 3212-3217 (1978). 

In ovarian cancer patients, small bowel obstruction is a common complication of progressive disease. In general, laxatives should not be used in patients with small bowel obstructions. 

Normen, L., Dutta, P., Lia, A., and Andersson, H. 2000. Soy sterol esters and beta-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am. J. Clin. Nutr. 71, 908-913. Normen, L., Brants, H. A. M., Voorrips, L.E., Andersson, H.A., van den Brandt, P.A., and Gold-bohm, R.A. 2001. Plant sterol intakes and colorectal cancer risk in the Netherlands cohort study on diet and cancer. Am. J. Clin. Nutr. 74, 141-148. 

Chronic administration increases the incidence of cholesterolic gallstones twofold. It also causes a small increase in thromboembolic phenomenon, pulmonary embolism, intermittent claudication, and angina pectoris. The drug may increase the incidence of bowel cancer. Overall, clofibrate cannot be classified as carcinogenic in humans. 

Adverse effects associated with XRT in colorectal cancer can be acute or chronic. Acute effects primarily include hematologic depression, dysuria, diarrhea, abdominal cramping, and proctitis. Chronic symptoms that sometimes persist for months following discontinuation of XRT may involve persistent diarrhea, proctitis or enteritis, small bowel obstruction, perineal tenderness, and impaired wound healing. 

Oral metoclopramide is indicated in the treatment of diabetic gastroparesis (10 mg 30 minutes before each meal and at bedtime for 2 to 8 weeks) and symptomatic gastroesophageal reflux (10 to 15 mg orally up to 4 times daily 30 minutes before each meal and at bedtime for 4 to 12 weeks). Furthermore, parenteral metoclopramide is indicated in prevention of nausea and vomiting associated with emetogenic cancer chemotherapy, for prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable, and as a single dose to facilitate small-bowel intubation when the tube does not pass the pylorus with conventional maneuvers. 

Fig. 15.5a,b. Colon cancer with obstruction, a Transverse sonogram of the left mid-abdomen shows thickening of the wall of the descending colon (arrows) in patient with partial obstruction of the colon, b The CT image shows symmetric thickening of the wall of the descending colon (arrow) and dilated small bowel loops... 

Lutgens, L.C., Blijlevens, N., Deutz, N.E., Donnelly, J.P., Lambin, R, and de Pauw, B.E. 2005. Monitoring myeloablative therapy-induced small bowel toxicity by serum citrulline concentration. Cancer, 103(1) 191-199. 

Fig. 10.31. Metastases from colon cancer. Sagittal CT shows a well-delineated mixed cystic and solid ovarian mass (arrow), which abuts the uterus fundus and elevates small bowel loops. No ascites was found in the pelvis or abdomen. In this patient with stage T4 colon cancer, differentiation of metastasis from ovarian cancer is not possible by imaging...

There is a slightly increased risk of developing colorectal cancer and lymphoma as a complication of the disease. These neoplasms mostly affect the small bowel. The presence of lymph node enlargement >10 mm in the short axis diameter should raise suspicion for malignancy. 

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