The purpose of this essay is to emphasise the necessity of detecting small bowel adenocarcinoma in patients with multifocal small intestinal strictures in tuberculosis-endemic areas such as India.
Objective: Because the management of small bowel adenocarcinoma differs significantly from that of intestinal tuberculosis, this article aims to emphasise the importance of suspecting malignancy in a patient with multifocal small bowel strictures, even if no classical risk factors for small bowel malignancy are present.
The Case Presentation: For four months, a 54-year-old man has been suffering from colicky central abdominal pain. Intestinal tuberculosis was suspected at the initial examination. He presented with acute intestinal obstruction two weeks later and was rushed to the hospital for emergency surgery, which revealed multiple non-passable strictures in the jejunum and ileum, which were resected and many anastomoses performed. Without any evidence of predisposing factors for small intestine adenocarcinoma, a biopsy revealed multifocal primary small bowel cancer.
One of the most common reasons for emergency laparotomies is acute intestinal blockage. Intestinal Tuberculosis is the most common cause of obstruction secondary to small bowel strictures in the Indian subcontinent, with Crohn's disease a distant second. Small bowel adenocarcinoma is not only uncommon, but it often presents with nonspecific symptoms, making diagnosis difficult. The cornerstone of treatment is surgical resection, and standard chemotherapy regimens are continually developing. Because small bowel adenocarcinoma usually manifests as a single infiltrating mass, our case is unusual in that it presents as several malignant strictures in the jejunum and ileum. Despite our patient's comprehensive histological and radiological evaluation, no known predisposing conditions, such as Crohn's disease or polyposis, could explain the multifocal appearance of small intestinal adenocarcinoma.
Conclusion: Despite all of the advances in diagnostic technology, preoperative identification of small bowel cancer is still uncommon. This case is being reported to emphasise the necessity of a differential diagnosis of small bowel adenocarcinoma in individuals with numerous small bowel strictures.Author(S) Details
V. R. Karthikayan
Department of Oncosurgery, Delhi State Cancer Institute, Dilshad Garden, Delhi- 110095. India.
Anil Kumar Singh
Department of Oncosurgery, Delhi State Cancer Institute, Dilshad Garden, Delhi- 110095. India.
View Book:- https://stm.bookpi.org/IDMMR-V1/article/view/5039
No comments:
Post a Comment