An atypical presentation of small bowel adenocarcinoma; a case report

Abstract Small bowel malignancy (SBM) is a rare malignancy in the gastrointestinal tract. Duodenum is the most commonly involved segment and the most common histological subtype is adenocarcinoma (40%). Due to a lack of screening tools and vague symptoms, its clinical detection is very challenging. A 27-year-old man presented at the surgical emergency of Lahore General Hospital in February 2019 with non-specific gastrointestinal symptoms (vomiting, abdominal pain), for which he had previously visited the hospital multiple times. Later, on further workup, he had been diagnosed as a case of intussusception on CT scan. On exploration, he had an impassable stricture in the jejunum. Resection anastomosis of the jejunum was done, but later, on histopathology it turned out to be adenocarcinoma. Adenocarcinoma of the small bowel is a rare entity, and, particularly in Pakistan, Continuous...

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Small Bowel Adenocarcinoma, Version 1.2020, NCCN Clinical Practice Guidelines in Oncology

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2019.0043 ◽

2019 ◽

Vol 17 (9) ◽

pp. 1109-1133 ◽

Cited By ~ 15

Author(s):

Al B. Benson ◽

Alan P. Venook ◽

Mahmoud M. Al-Hawary ◽

Mustafa A. Arain ◽

Yi-Jen Chen ◽

...

Keyword(s):

Colorectal Cancer ◽

Small Bowel ◽

Treatment Options ◽

Standard Of Care ◽

Primary Treatment ◽

Evidence Based ◽

Small Bowel Adenocarcinoma ◽

Advanced Stage ◽

Nccn Guidelines ◽

Rare Malignancy

Small bowel adenocarcinoma (SBA) is a rare malignancy of the gastrointestinal tract that has increased in incidence across recent years. Often diagnosed at an advanced stage, outcomes for SBA are worse on average than for other related malignancies, including colorectal cancer. Due to the rarity of this disease, few studies have been done to direct optimal treatment, although recent data have shown that SBA responds to treatment differently than colorectal cancer, necessitating a separate approach to treatment. The NCCN Guidelines for Small Bowel Adenocarcinoma were created to establish an evidence-based standard of care for patients with SBA. These guidelines provide recommendations on the workup of suspected SBA, primary treatment options, adjuvant treatment, surveillance, and systemic therapy for metastatic disease. Additionally, principles of imaging and endoscopy, pathologic review, surgery, radiation therapy, and survivorship are described.

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Case Report: Molecular Features and Treatment Options for Small Bowel Adenocarcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.593561 ◽

2021 ◽

Vol 11 ◽

Author(s):

Miguel Cordova-Delgado ◽

Gonzalo Pizarro ◽

Mauricio P. Pinto ◽

Maria Elisa Herrera ◽

Marcelo Garrido

Keyword(s):

Small Bowel ◽

Treatment Options ◽

Stage Iv ◽

Tumor Type ◽

Small Bowel Adenocarcinoma ◽

Molecular Alterations ◽

Molecular Features ◽

Genetic Landscape ◽

Rare Malignancy ◽

Gene Alterations

Small bowel adenocarcinoma (SBA) is a rare malignancy characterized by poor prognosis. Recent efforts have sought to elucidate the genetic landscape and the molecular drivers behind this disease. Herein, we report the main molecular alterations in two metastatic (stage IV) SBA patients. Interestingly, one of them had gene alterations that affected signaling pathways previously described for SBA. However, a second patient displayed previously unreported alterations in this particular tumor type. Based on these findings we discuss potential treatment options for patients affected by this rare, aggressive disease.

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05 / Dopamine-secreting ganglioneuroma: anaesthetic management of a rare entity with an atypical presentation

10.26226/morressier.5aeb0ac607b0d6001a79a167 ◽

2018 ◽

Author(s):

João Mendes ◽

Maria Beatriz Carvalho Bello Dias

Keyword(s):

Anaesthetic Management ◽

Atypical Presentation ◽

Rare Entity

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A Trial to Evaluate the Potential Benefit of Adjuvant Chemotherapy for Small Bowel Adenocarcinoma

Case Medical Research ◽

10.31525/ct1-nct04257461 ◽

2020 ◽

Author(s):

Keyword(s):

Adjuvant Chemotherapy ◽

Small Bowel ◽

Potential Benefit ◽

Small Bowel Adenocarcinoma

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Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

Veterinary Sciences ◽

10.3390/vetsci8050083 ◽

2021 ◽

Vol 8 (5) ◽

pp. 83

Author(s):

Jae-Eun Hyun ◽

Hyun-Jung Han

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Surgical Intervention ◽

Gastrointestinal Symptoms ◽

Exploratory Laparotomy ◽

Abdominal Adhesions ◽

Abdominal Radiography ◽

Foreign Body Removal ◽

Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

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Gastrointestinal Physiology Before and After Duodenal Switch with Comparisons to Unoperated Lean Controls: Novel Use of the SmartPill Wireless Motility Capsule

Obesity Surgery ◽

10.1007/s11695-021-05452-4 ◽

2021 ◽

Author(s):

Khalid Elias ◽

Per M. Hellström ◽

Dominic-Luc Webb ◽

Magnus Sundbom

Keyword(s):

Small Bowel ◽

Transit Time ◽

Duodenal Switch ◽

Rating Scale ◽

Gastrointestinal Symptoms ◽

Small Bowel Transit ◽

Gastrointestinal Physiology ◽

Time Points ◽

Small Bowel Transit Time ◽

Wireless Motility Capsule

Abstract Purpose Bariatric surgery alters gastrointestinal anatomy. In this exploratory study, the SmartPill® wireless motility capsule (WMC) was used to study changes in gastrointestinal physiology following biliopancreatic diversion with duodenal switch (BPD/DS). Material and Methods Twenty-eight BPD/DS patients (35 ± 11 years, 50% females, body mass index [BMI] 56 ± 5) were to be examined preoperatively and postoperatively. In addition to transit time, appetite control and gastrointestinal symptoms were studied by patient-scored questionnaires (visual analogue scale and Gastrointestinal Symptom Rating Scale (GSRS)). Data was compared to 41 lean unoperated controls. Results About 1.8 years postoperatively, 18 patients (BMI 35.8 ± 8.3) returned for a second WMC test. As expected, small bowel transit time was reduced, from 3.9 ± 1.6 h to 2.8 ± 2.0, p = 0.02, and at both these time points, it was shorter than in lean controls (5.4 ± 1.9 h, p = 0.001). Postoperatively, a trend towards reduced colon and whole gut transit times was seen in BPD/DS-patients, thus approaching those of lean controls. Surprisingly, BPD/DS patients scored higher satiety than controls preoperatively as well as increased hunger and desire to eat postoperatively. Compared to lean, BPD/DS patients reported a higher total GSRS score at both time points (1.2 ± 0.2 vs 1.7 ± 0.6 and 2.3 ± 0.5, p < 0.001). Postoperatively, the scores for diarrhea and indigestion increased. Conclusions The novel use of the SmartPill system in BPD/DS patients gave the expected readouts. Although small bowel transit time was further shortened after BPD/DS, whole gut transit time did not differ from controls. Typical gastrointestinal symptoms were reported postoperatively. Graphical abstract

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