Small Bowel Adenocarcinoma-A Case Report

International Journal of Research and Scientific Innovation (IJRSI) | Volume VI, Issue V, May 2019 | ISSN 2321–2705

Small Bowel Adenocarcinoma-A Case Report

Dr. Michael Abiodun Adeyanju¹, Dr. Omobolade Olajumoke Obadofin²

¹Consultant General Surgeon, Department of Surgery, General surgery unit, Federal Medical Centre, Ebute Metta, Lagos. Nigeria.
²Consultant Pathologist, Federal Medical Centre, Ebute –Metta, Lagos. Nigeria.

Abstract: – This is a case report of a case of Small Bowel Adenocarcinoma in a 39-year old male who presented with acute intestinal obstruction and was treated with Resection and anastomosis of the involved segment of bowel and chemotherapy. Histopthologic diagnosis was Adenocarcinoma of the Small Bowel. CDX2 evaluation was positive while synaptophysin was negative.
Clinical presentation is ambiguous in the early stages and some patients are thought to be malingering and/or treated for something else. High index of suspicion is important for correct early diagnosis and prompt treatment to prevent emergency presentation and metastatic disease.

Keywords: – Small Bowel Adenocarcinoma (SBA), Colorectal Cancer (CRC), Gastrointestinal (GI), Carcinoid, Immunoglobulin A (IGA), CDX2.

I. INTRODUCTION

The small bowel is that part of the Gastro-intestinal tract that extends from the duodenum to the Ileum. It makes up 75% of the digestive tract and 90% of its mucosa area1. However, in spite of its relatively large size, malignancies are very rare in the small bowel, accounting for 2-5% of GI cancers1,2. There are 4800 new cases per year in the US with 1200 deaths3.
There is paucity of information on the incidence, presentation and management of these cancers due to its relative rarity.
Four types of cancers2,3 in the small bowel have been identified. These include Adenocarcinoma, neuroendocrine tumours (malignant carcinoid), gastrointestinal stromal tumours and lymphomas. Of these, malignant carcinoid is presently thought to be commonest4. However, adenocarcinoma is the commonest in the duodenum.
Risk factors for the disease include alcohol intake5, cigarette smoking6, and high sugar consumption. These increase the risk. Reduction in risk is found in high intakes of fruits and vegetables7.
Predisposing conditions include Peutz-Jerghers syndrome, Crohn’s disease and celiac disease1.

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