Case Report
Copyright ©2012 Baishideng. All rights reserved.
World J Gastrointest Oncol. Jul 15, 2012; 4(7): 184-186
Published online Jul 15, 2012. doi: 10.4251/wjgo.v4.i7.184
Adenocarcinoma of the small bowel in a patient with occlusive Crohn’s disease
Lior Drukker, Yair Edden, Petachia Reissman
Lior Drukker, Yair Edden, Petachia Reissman, Department of General Surgery, Shaare Zedek Medical Center, Hebrew University, Hadassah School of Medicine, PO Box 3235, Jerusalem 91031, Israel
Author contributions: Drukker L and Reissman P performed the surgical procedure and provided clinical data; Drukker L and Edden Y wrote the case report; all authors revised the paper and approved the final version.
Correspondence to: Petachia Reissman, MD, Professor of Medicine, Chief of General Surgery Department, Shaare Zedek Medical Center, Hebrew University, Hadassah School of Medicine, PO Box 3235, Jerusalem 91031, Israel. reissman@szmc.org.il
Telephone: +972-2-6666310 Fax: +972-2-6666253
Received: August 18, 2011
Revised: May 29, 2012
Accepted: May 31, 2012
Published online: July 15, 2012
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: Inflammatory bowel disease; Crohn’s disease; Small bowel obstruction; Small bowel stricture; Small bowel adenocarcinoma