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Diagnostic and Staging Work-Up

  • Patients with small bowel neoplasms may present with any number of the following: 
    • abdominal pain, 
    • obstructive symptoms, 
    • bleeding, 
    • anorexia, 
    • weight loss, 
    • or in the case of a duodenal primary, jaundice.
  • Upper GI series with small bowel follow through may show a mass lesion, mucosal defect or intussusception.
  • CT scan of the abdomen and ​pelvis is generally done to assess the presenting symptoms and will reveal the extent of disease.
  • Upper GI endoscopy may detect a tumour in the duodenum and allow for biopsy for tissue diagnosis.
  • Wireless video capsule endoscopy is a means of visualizing the entire small bowel. However, it does not permit tissue sampling and should not be done in someone suspected of having bowel obstruction.
  • Exploratory laparoscopy or laparotomy may be required for diagnostic as well as therapeutic purposes.
  • PET scans are not recommended for staging purposes.
  • Pre-operative tumour markers: CEA, CA 19-9 and CA-125 may be useful for future monitoring.
  • Given the rarity of these cases, referral to BCCA is recommended.

SOURCE: Diagnostic and Staging Work-Up ( )
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