Knobel B, Biro A, Zaidel L, Siderer M
Harefuah. 1989 Mar 15;116(6):305-7.
Carcinoid of the small intestine, usually found in the terminal ileum, presents a diagnostic challenge when the classic clinical and laboratory findings are absent. The commonest symptom, marked abdominal pain due to intussusception, may arouse suspicion of carcinoid. The precise preoperative diagnosis in the absence of the classic syndrome is impossible and the only way to diagnose it is by colonoscopic biopsy of the terminal ileum. The case described illustrates such a preoperative diagnosis in a 59-year-old woman with severe abdominal pain, nausea, vomiting and weight loss. X-ray studies aroused suspicion of tumor intussusception as the cause of the intestinal obstruction. Colonoscopic biopsy revealed the presence of a carcinoid tumor. However, there had been no symptoms of the carcinoid syndrome, nor was there increased urinary 5-hydroxy indoleacetic acid. On operation the tumor was found to be disseminated and unresectable, so surgical intervention was limited to palliative ileo-transversostomy.
小肠类癌通常位于回肠末端，当缺乏典型的临床和实验室检查结果时，诊断颇具挑战性。最常见的症状是因肠套叠引起的剧烈腹痛，这可能会引发对类癌的怀疑。在没有典型综合征的情况下，术前精确诊断是不可能的，诊断的唯一方法是对回肠末端进行结肠镜活检。所描述的病例是一名59岁女性，有严重腹痛、恶心、呕吐和体重减轻症状，术前诊断即为如此。X线检查怀疑肿瘤性肠套叠是肠梗阻的原因。结肠镜活检显示存在类癌肿瘤。然而，并没有类癌综合征的症状，尿5-羟吲哚乙酸也没有升高。手术时发现肿瘤已扩散且无法切除，因此手术干预仅限于姑息性回肠横结肠造口术。
