Radiological appearances of small intestinal leiomyomas

During a 5 year period we have identified leiomyomas of the small intestine in six patients using enteroclysis. Gastrointestinal bleeding were the presenting symptoms in five and partial small bowel obstruction in one. The time interval between the onset of symptoms and radiological diagnosis ranged between 3 months and 5 years. All patients had previously been investigated by a number of endoscopic and barium radiology examinations and one had undergone a nondiagnostic laparotomy. The jejunum was the site of involvement in one patient and the ileum in five. The growth was intraluminal in two cases, extraluminal in three and bidirectional (dumb-bell) in one. Radiological appearances included round or broad-based semilunar intraluminal filling defects with encroachment of the lumen, or intussusception, displacement and/or indentation of the intestinal wall with effacement of the overlying mucosa or an ulcer crater, tenting deformity and mass effect on neighbouring loops. All six patients came to operation. Pre-operative radiological diagnosis was correct in five and suggestive in one. There was excellent correlation between the radiological appearances and morphology of the pathology specimens.