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. 2012 Jul 15;4(7):184-6.
doi: 10.4251/wjgo.v4.i7.184.

Adenocarcinoma of the small bowel in a patient with occlusive Crohn's disease

Lior Drukker  1 , Yair Edden, Petachia Reissman
Affiliations

Adenocarcinoma of the small bowel in a patient with occlusive Crohn's disease

Lior Drukker et al. World J Gastrointest Oncol. .

Abstract

A 40-year-old male, diagnosed with mild Crohn's disease (CD) 11 years ago but with no prior abdominal surgeries, was diagnosed with a small bowel stricture, due to ongoing abdominal pain and intolerance of enteral diet, and referred for surgical treatment. Exploratory laparoscopy revealed a white solid mass causing a near total jejunal obstruction with significant proximal dilatation. An adjacent small node was sampled for frozen biopsy, revealing a lymph node infiltrated with adenocarcinoma. Laparoscopic assisted small bowel resection and appendectomy were carried out. Final pathological results supported the initial report of diffuse small bowel adenocarcinoma. In conclusion, once a small bowel stricture associated with CD is suspected, rapid action should be considered to avoid late diagnosis of a neoplasia.

Keywords: Crohn’s disease; Inflammatory bowel disease; Small bowel adenocarcinoma; Small bowel obstruction; Small bowel stricture.

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Figures

Figure 1
Figure 1
Abdominal computed tomography scan revealing a classic radiological finding of Crohn’s disease: Thickened jejunal wall with pre stenotic dilatation, as well as congestion of the mesenterial blood vessels.
Figure 2
Figure 2
Primary adenocarcinoma of the jejunum, after dividing the mesenterial vascular supply.
See this image and copyright information in PMC

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