Small bowel carcinoma

Case contributed by Dr Ian Bickle

Presentation

Intermittent colicky abdominal pain. Weight loss and iron deficiency anaemia.

Patient Data

Age: 52
Gender: Female
CT

Short segment intusseception with a mass as a lead point in the jejunum.  No small bowel obstruction.

Pathological small bowel mesenteric nodes.

Large peritoneal deposit in the midline in the pelvis.

Photo

Intra-operative specimens

The intra-operative and gross surgical specimens accurately correspond with the CT findings in the jejunum.

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The histopathology of the small bowel, mesenteric nodes and peritoneal deposit all contains adenocarcinoma of the jejunum.

Case Discussion

Primary adenocarcinoma of the small bowel is about 50 times less common than colonic carcinoma.

One of the more common methods of presentation is with a intusseception, the tumour acting as a lead-point.  A chief differential in an adult is small bowel lymphoma.

The commonest site for a small bowel adenocarcinoma is the dudoneum, followed by jejunum as in this case.

 

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Case information

rID: 39194
Case created: 25th Aug 2015
Last edited: 26th Oct 2015
Inclusion in quiz mode: Included

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