The elusive small bowel adenocarcinoma in the terminal ileum-A case report

International Journal of Surgery Case Reports
Joyce Lok Gee Ma, Paul Norman Strauss

Abstract

Small bowel malignancies are rare and often present with non-specific symptoms. Because of this, diagnosis of small bowel malignancies is often missed. 71-year-old male presented with a four-week history of right iliac fossa pain and loss of weight. Laboratory tests showed a raised C-reactive protein, but all other pathology results and tumour-associated antigens were normal. Computed tomography (CT) of the abdomen demonstrated an inflammatory mass extending laterally into the pelvic wall. The patient underwent an elective laparotomy and resection of the small bowel tumour. Intra-operative findings included a small bowel tumour adherent to two loops of small bowel. Histology demonstrated a 50 mm poorly differentiated mucinous adenocarcinoma of the terminal ileum. Clinical presentation of small bowel adenocarcinoma is often non-specific, which leads to a delay in diagnosis. As a result, disease is often advanced by the time of diagnosis. Upper and lower endoscopy is useful in detecting tumours in the duodenum and terminal ileum. Video capsule endoscopy allows visualisation of the entire small bowel mucosa. Enteroscopy can also be used to obtain biopsies and perform therapeutic interventions. CT is able to detect abnormalities in...Continue Reading

Citations

Oct 1, 2021·ANZ Journal of Surgery·Allan M F KwokBrian Draganic

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