Phytobezoars as a cause of small bowel obstruction associated with a carcinoid tumor of the ileocecal area.
Carcinoid tumors are slowly growing malignant neoplasms associated with an indolent clinical course. About 60% of such tumors are located within the gastrointestinal tract. We describe an unusual case of small bowel obstruction associated with a carcinoid tumor of the ileum. A 70-year-old woman was presented with abdominal pain, vomiting, and clinical signs of mechanical bowel obstruction. X-ray and CT-scan of the abdomen showed hydroaeric levels and the presence of intraluminal hyperdense "stones", presumably of gallbladder origin. A diagnostic laparotomy revealed that a large part of the terminal ileus was edematous, with prominent evidence of intestinal loop adhesions. The edematous part of the ileum was resected. Incision of the intestinal wall revealed a 2-cm soft mass at 8 cm from the ileocecal valve, where the presence of ten fruit pits obstructed the intestinal cavity. Histopathological examination confirmed the diagnosis of a carcinoid tumor. An interesting case of small-bowel obstruction with a double cause is presented: an ileal carcinoid and fruit pit bezoars. The pathophysiology of the obstruction is discussed.
Second Department of Surgery, Medical School Democritus University of Thrace, Alexandroupolis, Greece.
M
M
Pitiakoudis
M
M
Koukourakis
A
A
Giatromanolaki
Alexandra K
AK
Tsaroucha
A
A
Polychronidis
C
C
Simopoulos
D000368:Aged; D001630:Bezoars / Q000150:complications* / Q000175:diagnosis; D002276:Carcinoid Tumor / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications* / Q000175:diagnosis; D007080:Ileocecal Valve; D007415:Intestinal Obstruction / Q000150:complications* / Q000175:diagnosis