Intestinal obstruction after trauma laparotomy: a rare case due to colon cancer

The causes of intestinal obstruction are diverse with tissue adhesion, incarcerated hernia, and large bowel neoplasm being the most common causes. Cancer is not easy to diagnose in patients with a history of intestinal obstruction after the intraperitoneal operation following blunt trauma. Herein, we report the case of a patient who was diagnosed with colon cancer after undergoing adhesiolysis due to intestinal obstruction.

Brunner’s Gland Adenoma – A Rare Cause of Gastrointestinal Bleeding: Case Report and Systematic Review

Brunner’s gland adenoma is an extremely rare benign small bowel neoplasm, often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics. In few cases, it tends to cause gastrointestinal hemorrhage or intestinal obstruction. We report here our experience with a 47-year-old woman with a Brunner’s gland adenoma of more than 6 cm in size, located in the first part of the duodenum and causing gastrointestinal bleeding. Initially, we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding. A rest endoscopic polypectomy with the submucosal dissection technique was planned. However, on request of the patient, an elective surgical duodenotomy with submucosal resection of the remaining small duodenal tumor was performed. To better define the patient’s characteristics and treatment options of such lesions, we performed a systematic review of the available literature in PubMed. Recently, an endoscopic removal is being increasingly practiced and is considered as a safe treatment modality of such lesions.

Risk factors and the role of the family doctor in the small bowel neoplasm

Small bowel neoplasm is extremely rare, a reason for which it has a limited knowledge and understanding. Very few things are known about its etiology. Yet a high risk to develop a small bowel cancer was noted for patients with Crohn’s disease, celiac disease, familial adenomatous polyposis, and Peutz-Jeghers syndrome. A few modifiable risk factors were incriminated, such as the consumption of smoked meat, saturated fats, obesity and smoking, which also increase the incidence of small bowel neoplasm. Thus, it was observed that more considerable research is required, as well as more consistent statistical data, to understand better the etiology and biology of this type of cancer. We need to mention that a higher commitment from the family doctor is needed in the prevention and dispensarization of this pathology.

Recurrent Midgut Bleeding due to Jejunal Angioleiomyoma

Angioleiomyoma being a type of true smooth muscle gastrointestinal tumors can lead to serious life-threatening gastrointestinal bleeding. We report a case of 21-year-old male patient with recurrent midgut bleeding. Contrast-enhanced CT revealed highly vascular small bowel neoplasm. The patient underwent laparotomy with bowel resection and recovered uneventfully. Histopathology revealed jejunal angioleiomyoma.

Small-Bowel Neoplasms: Role of MRI Enteroclysis

Small-bowel neoplasms are the 3%–6% of all gastrointestinal tract neoplasms. Due to the rarity of these lesions, the low index of clinical suspicion, and the inadequate radiologic examinations or incorrect interpretation of radiologic findings, a delay in diagnosis of 6–8 months from the first symptoms often occurs. Even if conventional enteroclysis and capsule endoscopy are the most common procedures used to accurately depict the bowel lumen and mucosal surface, their use in evaluating the mural and extramural extents of small-bowel tumors is limited. Instead multidetector computed tomographic enteroclysis and magnetic resonance enteroclysis have the potential to simultaneously depict intraluminal, mural, and extraintestinal abnormalities. In particular MR enteroclysis has an excellent soft tissue contrast resolution and multiplanar imaging capability. It can provide anatomic, functional, and real time information without the need of ionizing radiation. MR findings, appearances of the lesions, combined with the contrast-enhancement behavior and characteristic of the stenosis are important to differentiate small-bowel neoplasm from other nonneoplastic diseases.