Presentation
Abdominal pain and constipation
Patient Data
Findings:
Gastric band noted.
The small bowel mainly jejunal loops appears dilated with multiple air-fluid levels, along with collapsed distal ileum suggesting small-bowel obstruction, mostly secondary to relatively well-defined non-calcified mesenteric mass lesion seen in the left mid abdomen measuring about 4.7 x 3.5 cm causing tethering of the surrounding small bowel loops without obvious wall thickening or enlarged lymph nodes. This mass shows progressive postcontrast enhancement especially on delayed images raising possibility of fibrotic component .
No para aortic or mesenteric lymph node enlargement.
No free fluid or pneumoperitoneum.
Conclusion:
Small bowel obstruction secondary to tethering enhancing mesenteric mass with element of delayed hyperenhancement
Differential diagnosis includes: Desmoid tumor, Fibrotic stage of sclerosing enteritis and less likely Carcinoid tumor.
Case Discussion
The mass was surgically resected and the histopathology report showed:
''Features most in keeping with intra- abdominal desmoid type fibromatosis''
Desmoid type fibromatosis is a rare locally aggressive fibroblastic neoplasm with no potential for metastasis that can arise anywhere in the body.
Peak incidence third and fourth decade.
There is an association with familial adenomatous polyposis
Unable to process the form. Check for errors and try again.