Small Bowel Adenocarcinoma: 10-Year Experience in a Cancer Center-The Ottawa Hospital (TOH)

Trending of small bowel adenocarcinoma research from 2000 to 2022: A bibliometric analysis

Small bowel adenocarcinoma (SBA) is a rare tumor entity with a relatively poor prognosis. Diagnosis and management of SBA are still challenging despite recent advancement of diagnostic methods and publication of guidelines. This study aimed to analyze and visualize the trending of SBA research in the past 22 years in the 21st century through bibliometric analysis. Our study collected 1270 publication records of SBA from 2000 Jan 1st to 2022 December 31 from Web of Science and used VOSviewer and CiteSpace to analyze countries, institutions, journals, authors, references and keywords to present the latest trends in SBA research. The USA was the most productive country in terms of the total number of publications (n = 418). The Mayo Clinic (n = 22) and University of Texas MD Cancer Center (n = 22) were the institutions with top publications. The "World Journal Of Gastroenterology" (n = 30) had the largest publications. Overman Michael J (n = 17) was the most active and prolific author. The "small bowel adenocarcinoma" was the most frequent keyword. Our bibliometric analysis provides a comprehensive overview of the trends and gaps in the research of SBA. Despite the challenges faced, researchers from USA, Japan and China have made significant contributions to the field of SBA research, and further research is necessary to develop evidence-based guidelines, and advance the understanding and management of SBA.

A systematic review and meta-analysis of magnetic resonance and computed tomography enterography in the diagnosis of small intestinal tumors

Objective

To explore the potential value of magnetic resonance (MR) and computed tomography (CT) enterography in the diagnosis of small intestinal tumor (SIT).

Methods

Articles reporting on the diagnosis of SIT by MR and CT enterography deposited in Chinese and foreign literature databases were identified and evaluated using the quality assessment of diagnostic accuracy studies (QUADAS). The diagnostic data extracted from the articles were adopted for meta-analysis using Meta-disc 1.40 software. Analysis was undertaken to compare the sensitivity, specificity, positive and negative likelihood ratios, and the diagnostic odds ratio (DOR) of MR and CT enterography in the diagnosis of SIT. The diagnostic values of the two imaging methods were analyzed by summary receiver operating characteristic (SROC) curves. The meta-analysis was registered at INPLASY (202380053).

Results

A total of eight articles, including 551 cases of SIT were included in this analysis. The pooled sensitivity and specificity of MR enterography were 0.92 (95% CI [0.89-0.95]) and 0.81 (95% CI [0.74-0.86]), respectively, whilst CT enterography had a sensitivity of 0.93 (95% CI [0.90-0.95]) and a specificity of 0.83 (95% CI [0.76-0.88]). For MR enterography, the combined positive likelihood ratio was 4.90 (95% CI [3.50-6.70]), the combined negative likelihood ratio was 0.10 (95% CI [0.07-0.14]), and the area under the receiver operating characteristic curve (AUROC) was 0.940. For CT enterography, the corresponding values were 5.40 (95% CI [3.90-7.40]), 0.08 (95% CI [0.06-0.12]), and 0.950, respectively. When the pretest probability for MR was assumed to be 50%, the posterior probabilities for positive and negative results were calculated as 83% and 9%, respectively. For CT enterography with a pretest probability of 50%, the posterior probabilities of positive and negative results were 84% and 8%, respectively.

Conclusion

MR and CT enterography have high accuracy in the diagnosis of SIT and have a valuable role in the diagnosis and management of these tumors.

Primary Adenocarcinoma of the Jejunum: Case Report of Rare Small Bowel Neoplasm

Small bowel adenocarcinoma (SBA) is rare cancer that accounts for less than 2% of all gastrointestinal tract cancers. Usually, the clinical presentation is unspecific, and a patient might complain of nausea, vomiting, abdominal pain, small bowel obstruction, and small bowel bleeding. Because of these unspecific symptoms, the patient might be diagnosed late, from six to ten months, which affects the prognosis. This study contains a case report of a 38-year female with SBA in the jejunum, with unspecific symptoms. She had a history of recurrent admissions due to acute pancreatitis, acute kidney injury, and hyponatremia caused by dehydration. The patient was diagnosed six months after the first symptoms of nausea and vomiting started. The patient underwent exploratory laparotomy for a jejunal stricture mass, and a lymph node was resected. The course after surgery was smooth, and the patient was discharged home on the fourth-day post-surgery. In conclusion, the symptoms of SBA are unspecific and cannot be diagnosed without complete medical histories and lab examinations, making diagnosing SBA challenging.