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• W2012102755 abstract "Carcinoids or argentaffinomas are rare tumors originating in the argentaffin cells situated at the bases of the crypts of Lieberkühn in the gastro-intestinal tract. They are usually benign and of no clinical significance. We have, however, encountered three cases of malignant small bowel carcinoids, one at the New Haven Hospital and two at the University of California Hospital. Since no instance of a preoperative diagnosis of such tumors has been found in the literature, and since the diagnosis in our second case was made before operation, on the basis of the post-operative findings in the first case, we believe we have recognized a roentgen sign indicative of the presence of these neoplasms. In the typical case, the patient is a middle-aged man or woman, who complains of long-standing gaseous distention, bloating, periumbilical pain, and steadily increasing loss of weight. Occasionally he has diarrhea and he may have “rumbling” or “rushes” in the abdomen. The clinical picture is one of chronic and increasing partial obstruction of the small bowel. The distention is usually so great that no tumor is palpable. The guaiac test for blood in the stool is usually negative since the tumors do not ulcerate or bleed. Roentgenologically the small bowel is seen to be distended with gas and fluid up to a point of partial obstruction. On careful examination at the site of obstruction, a small filling defect can be found and the bowel is seen to be kinked. Since the primary lesion is usually small, the obstruction is due to knuckling of the bowel and not to the tumor. It is the coexistence of kinking and tumor of the bowel which suggests the diagnosis. Other small-bowel tumors, such as polyps, lipoma, and carcinoma, produce obstruction because of intraluminary growth of the lesion or intussusception of the bowel. In the first case to be reported here the diagnosis was made postoperatively. In the second case, the diagnosis was considered as tenable because of the symptomatology and the presence of tumor at a point of kinking of the jejunum. These two cases present a fairly typical syndrome. A number of similar cases are described in the literature. The third case is of interest in that the first lesion recognized was in the rectosigmoid and proved to be a metastasis from a malignant carcinoid primary in the ileum. It emphasizes the nature of the spread of these metastases through the wall of the bowel with little encroachment upon the lumen. The constricting infiltration of the wall of the bowel and the mesentery causes varying degrees of obstruction. Case Reports Case 1: A 50-year-old man was admitted to New Haven Hospital in December 1939 complaining of “grabbing pains” which began just below the umbilicus and radiated toward the epigastrium." @default.
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• W2012102755 date "1942-08-01" @default.
• W2012102755 modified "2023-09-26" @default.
• W2012102755 title "Argentaffin Tumors of the Small Bowel: A Roentgen Sign of Malignant Change" @default.
• W2012102755 doi "https://doi.org/10.1148/39.2.214" @default.
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