Jejunal Adenocarcinoma as a Rare Cause of Small Bowel Obstruction: A Case Report

Abstract

Jejunal adenocarcinoma, a small bowel adenocarcinoma (SBA), is a rare cause of small bowel obstruction. Jejunal adenocarcinoma classically presents with vague clinical symptoms, i.e., abdominal pain, discomfort, and weight loss, making timely diagnosis challenging. Owing to its diagnosis at a late stage, the prognosis of jejunal adenocarcinoma is poor. Curative resection of the tumor at the early stages remains a treatment of choice. Here, we report a case of a 55-year-old man presenting with symptoms of nausea, vomiting, abdominal pain, abdominal distension, and relative constipation. Computed tomography (CT) scan showed dilated small bowel loops. Exploratory laparotomy was performed, which revealed a jejunal stricture and dilated small bowel loops proximal to it. Suspicious stricture, along with the diseased portion of the intestine, was removed through en-bloc resection. Histopathology and metastatic workup revealed moderately differentiated adenocarcinoma with stage IIB (T4aN0M0). We conclude that, although rare, jejunal adenocarcinoma should be kept in mind when dealing with a patient presenting with symptoms indicating small bowel obstruction. Our purpose is to emphasize laparotomy as both a diagnostic and surgical modality for SBAs in early stages, especially in setups of low economic countries where advanced imaging techniques are relatively inaccessible.

Keywords: jejunal adenocarcinoma; small bowel adenocarcinoma; small bowel obstruction; stricture.

Figure 1. Preoperative coronal computed tomography (CT) scan of the abdomen showing dilated small bowel loops (arrows).

Figure 2. Preoperative axial computed tomography (CT) scan of the abdomen showing dilated small bowel loops (arrows).

Figure 3. Intraoperative specimen showing suspicious growth stricture (arrow) at proximal jejunum and dilated small bowel loops proximal to it.