Adenocarcinoma ileum: a rare cause of ileal stricture mimicking intestinal tuberculosis: a case report and literature review

Authors

  • Manisha Aggarwal Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India
  • Dinesh Manchikanti Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India
  • Janitta Kundaikar Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India
  • Shaji Thomas Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India
  • Ashish Arsia Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India
  • Rahul Pusuluri Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India
  • Kusum Meena Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India
  • Sanjay Kumar Department of Surgery, Lady Hardinge Medical College and Dr RML Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20213149

Keywords:

Adenocarcinoma ileum, Small intestinal obstruction, Ileal stricture, Small intestinal tuberculosis

Abstract

One of the commonest causes of small intestinal obstruction in India is tuberculosis. The terminal ileum and ileocaecal junction are the most common sites of small bowel involvement, and the most common abnormality is short-segment strictures. We report a patient who presented with small intestinal obstruction due to a solitary ileal stricture, but turned out to be a rare condition that can mimic intestinal tuberculosis. A 60-years-old man, with recurrent episodes of pain abdomen for 1 year, presented to our surgical emergency with evidence of small intestinal obstruction. A CT scan revealed a short segment stricture (2.7 cm) in mid ileal loop with luminal narrowing and marked proximal dilation of proximal ileal loops with a few sub centimetric mesenteric lymph nodes. On laparotomy with a suspected diagnosis of intestinal tuberculosis, it turned to be an adenocarcinoma of the ileum- a rare condition that can mimic intestinal tuberculosis. One of the commonest causes of small intestinal obstruction in India is abdominal tuberculosis. However, all cases of small intestinal obstruction are not tuberculosis. Adenocarcinoma of ileum is a very rare entity. This case report shows that a surgeon should have a high index of suspicion in an elderly patient presenting with small intestinal obstruction, with CT demonstrating isolated short-segment small bowel thickening, as it could be a presentation of obstructing type adenocarcinoma of the small intestine.

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Published

2021-07-28

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Case Reports