Benign and malignant diseases of the small bowels, types of surgeries

1. Big picture

Small bowel diseases are surgically important because the small intestine is long, mobile, vascular, and essential for digestion, absorption, fluid balance, and nutrition. The surgeon’s job is to decide whether the problem is:

Obstruction → Bleeding → Ischemia → Perforation → Tumor → Inflammatory stricture/fistula

The small bowel includes the duodenum, jejunum, and ileum. Benign disease is much more common than malignant disease, but malignant tumors are important because they are often diagnosed late with vague symptoms such as abdominal pain, anemia, obstruction, or weight loss.

For the oral exam, the main surgical logic is:

Stable patient → define disease with CT/endoscopy/enterography → elective or conservative plan
Unstable patient/peritonitis/ischemia/perforation → resuscitate → urgent operation
Tumor → stage → radical resection if curable → palliation if metastatic/unresectable

Small intestine malignancies are rare compared with gastric and colorectal cancer. NCI lists the major malignant types as adenocarcinoma, lymphoma, sarcoma/GIST, neuroendocrine tumor, and other sarcomas, and states that surgery is the predominant treatment when complete resection is possible. ([Cancer.gov][1])

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