Smooth Muscle Tumors of the Small Intestine: Analysis of 16 Cases

In order to evaluate the accuracy of pre-operative diagnosis of small bowel smooth muscle tumors in the emergency room (ER), we identified 10 patients with leiomyoma and 6 patients with leiomyosarcoma of the small intestine seen over a 6-year period most common presenting symptom was gastrointestinal bleeding, found in 75% of patients in our series. About half of our patients were symptomatic for more than six months prior to diagnosis. The best diagnostic examination appears to be celiac and superior mesenteric arteriography. Ten of 16 tumors were found on angiography. All 16 patients underwent surgery, with emergency procedures performed in2.One of these had massive upper gastrointestinal bleeding and the other was thought to have acute appendicitis. There was only 1 fatality, due to a post-operative pulmonary embolism. In conclusion, ER physicians should include small intestinal tumors in the differential diagnosis of patiens with recurrent gastrointestinal bleeding, anemia, abdominal pain with palpable mass, and intestinal obstruction.