TITLE:
Primary Small Bowel Tumour Presenting as Bowel Obstruction in a Patient with a Virgin Abdomen
AUTHORS:
Xilin Wu, Hester Y. S. Cheung, Cliff C. C. Chung, Michael K. W. Li
KEYWORDS:
Small Bowel Tumour; Bowel Obstruction; Virgin Abdomen
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.4 No.6,
June
17,
2013
ABSTRACT: Primary malignancies of the small bowel are rare
and usually present with vague, non-specific symptoms. This leads to diagnostic
difficulties for both physician and radiologists alike. We present a case of a
54-year-old lady with a virgin abdomen who initially presented to hospital with
vague abdominal symptoms suggestive of gastroenteritis. She responded partially
to conservative treatment but represented to hospital 3 weeks later with
obstructive symptoms. Contrast CT was inconclusive with regards to diagnosis. A
diagnostic laparoscopy was performed, revealing an infiltrative growth.
Consequently, she underwent segmental laparoscopic-assisted small bowel
resection and recovered well post-operatively.
After further histological and endoscopic investigations, a final diagnosis of
primary small bowel adenocarcinoma was given. As the prognosis of small bowel
malignancy is stage-dependent, this case demonstrates a high index of suspicion
is necessary to reach early diagnosis, especially for symptoms non-responsive
to conventional treatment. Diagnostic laparoscopy should be considered early as
a definitive diagnostic tool.