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.
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