Small Bowel Cancer

Diagnosis

Mayo Clinic doctors use high-resolution imaging studies, nuclear medicine scans, the latest in endoscopic procedures and other state-of-the-art methods to diagnose small bowel cancer.

Imaging studies

Your doctor will select the right type of imaging studies for your situation, such as one or more of those below. In tests that involve radiation, specialists carefully monitor doses to avoid the risk of radiation overexposure.

• Endoscopic ultrasound (EUS). For more-detailed images, an ultrasound probe is passed through a flexible tube (endoscope) into your stomach and intestines. A computer translates the sound waves sent around the small bowel into images that can identify tumors.
• Computerized tomography (CT) scans. CT scans generate 2-D images of the abdomen that may reveal whether cancer has spread to other tissues or organs. Technology at Mayo Clinic enables 3-D reconstruction of the CT images. Specialized CT scans focusing on visualizing the small bowel (CT enteroscopy) may be performed if necessary.
• Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves to create 2- and 3-D images to identify abnormalities in your small bowel.
• Positron emission tomography (PET). To perform a PET scan, doctors inject sugar (glucose) and a very small amount of radiation into your bloodstream. The scan helps show if a tumor has spread, because tumors typically pick up the sugar and appear on the image as "hot spots."
• Nuclear medicine scans. Special radioactive tracers can help locate certain small bowel tumors, particularly carcinoid tumors. This can help determine not only location and extent of disease, but also best treatment strategies.

Endoscopic imaging

In addition to the imaging tests above, specialists can examine your small bowel using these procedures:

• Endoscopy or colonoscopy. Doctors pass a thin tube down your throat and through the stomach (endoscopy) or up through the rectum (colonoscopy). A light inside the tube helps the doctor see abnormal areas in the small bowel. However, only the areas close to each end of the small bowel can be examined using these techniques. A small sample of cells can be taken for examination under a microscope by a pathologist (biopsy).
• Capsule endoscopy. This technology involves swallowing a pill-sized capsule that contains a light source and a tiny camera. Most of the small bowel can be examined using capsule endoscopy. The camera takes thousands of pictures of the small bowel before it is passed out of the body.
• Balloon-assisted enteroscopy. This technology allows the doctor to see much more of your small bowel compared to standard upper endoscopy or colonoscopy. It also allows for biopsy and treatment if needed. Double-ballon enteroscopy (DBE) uses two balloons. Single balloon enteroscopy (SBE) uses one balloon. The technique uses an endoscope with a sleeve-like device (overtube).
• Spiral enteroscopy. This enteroscope system also allows for a more extensive evaluation of your small bowel. Doctors place a small, spiral-shaped tube down your throat and then insert the enteroscope into the small bowel. Biopsies and treatment can be performed using this technique.

Biopsy

If the tumor can be reached, your doctor will likely use a small biopsy forceps or a fine needle to gather a sample of cells from your small intestine. Pathologists will examine this sample under a microscope.

Laparoscopy

Sometimes it may be necessary to do a laparoscopy, which involves making a small cut (incision) directly into the wall of the abdomen and using a telescope to look for signs of disease.

Read more about CT scan, MRI, PET scan, biopsy, colonoscopy, endoscopy and capsule endoscopy.