Primary malignant tumours in the small bowel. (A report about 43 of our own cases and 1134 cases from literature).

From 1953 until May 1975 6553 patients with malignant tumours of the gastrointestinal-tract were operated on the University Hospital for Surgery in Minich, and in 43 cases (0,67%) a primary small bowel neoplasm was found. In the available literature we gathered a few more than 2000 cases it was possible to compare the data of symptoms and clinical findings with our results. We came to the following conclusion: 1. The main symptoms are abdominal pains in 71% in the literature (83% in our own cases), changing of peristaltic in 52% (33%), melena in 48% (62%), weight loss in 47% (67%), nausea and vomiting in 34% (22%). 2. The Benzidine examination for blood in the stool was in 70 to 90% the cases positive, in 33% we found an aneamia and in 29% a palpable tumour mass. The X-ray contrast exploration is the simplest and best routine method to find the lesion. Recently the selective angiography and the endoscopy are a valuable aid for the diagnostic in the small bowell. 3. The prognosis of these tumours is one of the poorest of the whole tumour surgery. In 60% (81%) of the patients there were a metastazisation at the time of operation; the five year survival ranged from 5 to 32% (12,7% in our own cases). Only with greater awareness of the vague symptoms will it become possible to diagnose the small bowel tumour at an early stage.