title: [Primary adenocarcinoma of the terminal ileum, synchronous].
abstract: BACKGROUND
  Among the rarest types of cancer found are the small intestine malignancies, representing only 2% of all gastrointestinal cancer and 0.1-0.3% of all malignancies. The most common subtype of this tumour is the adenocarcinoma, which is located mainly in the duodenum, jejunum and, rarely, in ileum.
  
  
  METHODS
  A 75 year-old male, with no any surgical history, who in the previous three months, referred to two clinical episodes of partial bowel obstruction and unquantified weight loss. When admitted into the surgical service, the patient referred to a partial bowel obstruction of more than one week onset. A laparotomy was performed, finding 3 stenosis rings at the ileum end portion, carrying out an intestinal resection and enteral-enteral anastomosis. On the seventh day there was dehiscence of the anastomosis and abdominal sepsis. New surgery was performed with the resection of the intestinal anastomosis and an ileostomy. The pathologist report indicated a small bowel adenocarcinoma moderately differentiated, ulcerated, and multifocal. It was classified as stage III or T3N1M0. The patient progress was satisfactorily, managed as outpatient with postoperative chemotherapy with 5 fluorouracil and cisplatin. The patient died a year later due to liver metastases.
  
  
  CONCLUSIONS
  Due to the extreme rarity of the case, is very likely that general surgeons may find one or two cases of adenocarcinoma of the ileum in their professional career. Thus, they must suspect this pathology when faced with an episode of intestinal obstruction in the adult.
authors.affiliation: Departamento de Cirugía, Clínica Médico Quirúrgica Candia, Puebla, México. Electronic address: drcandiarf@gmail.com.
authors.forename: René Francisco
authors.initials: RF
authors.lastname: Candia-de la Rosa
authors.affiliation: Departamento de Cirugía, Clínica Médico Quirúrgica Candia, Puebla, México.
authors.forename: Raúl
authors.initials: R
authors.lastname: Sampayo-Candia
authors.affiliation: Departamento de Cirugía, Clínica Médico Quirúrgica Candia, Puebla, México.
authors.forename: José Christian
authors.initials: JC
authors.lastname: Bretón-Toral
authors.affiliation: Universidad Popular Autónoma del Estado de Puebla, Puebla, México.
authors.forename: Francisco
authors.initials: F
authors.lastname: Candia-Archundia
authors.affiliation: Departamento de Radiología, Clínica Médico Quirúrgica Candia, Puebla, México.
authors.forename: Raúl
authors.initials: R
authors.lastname: Candia-García
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000601:surgery; D008297:Male
keywords: Adenocarcinoma; Intestino delgado; Partial bowel obstruction; Small intestine; Suboclusión intestinal; Terminal ileum; Íleo terminal