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Several articles in Gut have highlighted the predisposition to small bowel carcinogenesis caused by either mismatch repair gene mutations1 or chronic mucosal wounding by conditions such as Crohn’s disease2 or coeliac sprue.3 Small bowel damage of the latter kind is associated with induction of the proangiogenic peptide, vascular endothelial growth factor (VEGF),4 which is in turn accompanied by expression of proinflammatory cyclo-oxygenases and the wound healing cytokine transforming growth factor β.4 Since a similar growth factor expression profile is recognised in small bowel adenocarcinoma (SBA)5—an uncommon malignancy in which even the minority of resectable …
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Patient consent: Obtained.
▸ Competing interests: Declared (the declaration can be viewed online only at http://gut.bmj.com/content/vol57/issue11.