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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

BACKGROUND Primary small bowel cancer is a rare malignancy; the common histopathological types are carcinoid and adenocarcinoma. Inflammatory bowel diseases and familial adenomatous polyposis are known risk factors for small bowel cancer. Additionally, cases of surgery-induced small bowel adenocarcinoma are sometimes reported after ileostomy. CASE REPORT A 84-year-old woman, who had undergone ileotransversostomy for intestinal obstruction due to postoperative adhesion following appendectomy at the age of 31 years, was referred to our hospital for further examination after experiencing abdominal pain in the right lower quadrant for 2 weeks. Laboratory data showed elevated serum levels of carcinoembryonic antigen (CEA, 102.9 ng/ml) and carbohydrate antigen 19-9 (CA19-9, 104 U/ml). Enhanced computed tomography (CT) revealed a 10-cm mass in the terminal ileum and a distention of the ileum and colon in the blind loop, with retention of feces. The patient was suspected of having ileal cancer by preoperative examination; therefore, right hemicolectomy with en bloc resection was performed. The tumor was histopathologically diagnosed as a well-differentiated and mucinous adenocarcinoma of the ileum. At over 12 months after surgery, tumor recurrence had not been observed. CONCLUSIONS Difficulties in diagnosis can cause delays in treatment and lead to poor prognosis, mainly because tumors in the small bowel rarely cause clinical symptoms. Adenocarcinoma of the ileum should be considered in postoperative patients with ileotransversostomy.
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PMID:Adenocarcinoma in a Blind Loop of the Ileum 53 Years After an Ileotransversostomy Procedure. 2940 80

Small bowel cancers are a rare group of cancers of the gastrointestinal tract. Adenocarcinoma of ileum is an even rarer pathology to come across. We had a case of small bowel adenocarcinoma (SBA) who presented with recurrent abdominal pain and vomiting to different local hospitals. Abdominal ultrasound showed dilated bowel 4.7cm in size with sluggish movement. Patient was treated symptomatically for 3 months with poor outcome. Then patient presented in our hospital as an e m e r g e n c y w i t h i n t e s t i n a l o b s t r u c t i o n a n dhaemodynamic instability. Exploratory laprotomy was performed after initial optimization. A hard stricture was found in ileum. The segment of ileum with suitable margins was resected and loop ileostomy was performed. Histopathology findings indicated an adenocarcinoma of ileum. Our rationale to report this case is to raise awareness among physicians about SBA in patients with vague abdominal pain and vomiting, and the fact that negligence in diagnosing this rare cancer can turn it into a surgical emergency which increases the morbidity and mortality in patients.
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PMID:Adenocarcinoma of ileum: a case report. 3100 Aug 67

Invasive adenocarcinoma of the ileum is a rare tumor with an incidence of 0.59 per 1 million. Given its location in the distal portion of the small bowel, it is difficult to diagnose early and is often only discovered during surgery. This challenge leads to late diagnoses and poor prognosis. Surgical resection is the gold standard for treatment, with adjuvant therapy occasionally playing a supporting role. We present the case of a 62-year-old male with a complex past medical history, including non-small cell lung cancer with metastases to brain and treated with irradiation and left parietal craniotomy 13 years prior to presentation. Our patient presented to a community hospital complaining of abdominal pain. Findings on abdominal computerized tomography (CT) with intravenous (IV) contrast was consistent with a mechanical obstruction of the small bowel. The patient was admitted to the general medical floor for non-operative management. However, after three days of unsuccessful non-operative management, he was taken to the operating room for diagnostic laparoscopy. Surgery revealed an obstructing mass in the distal third of the ileum, which was excised and found to be invasive adenocarcinoma on histology. Adenocarcinoma of the ileum is very difficult to diagnose preoperatively. As a result, it often leads to delays in treatment and a poor prognosis in many patients, including ours. Because of its very low prevalence, a high index of suspicion is required to make an early diagnosis and obtain definitive treatment.
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PMID:Invasive Adenocarcinoma of the Ileum Presenting as a Small Bowel Obstruction. 3329 96