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STRICTURE CAUSED BY CARCINOID TUMOUR, PRESENTED AS SMALL BOWEL OBSTRUCTION - A CASE REPORT.

RAJESWARAN AYYANAR

Abstract


Abstract :
Background. Neuroendocrine tumours
(NETs) of the jejunum and ileum are part
of a heterogeneous group of gastrointestinal
and pancreatic endocrine tumours.
Carcinoid tumor arises from enterochromoffin
cells at the base of crypts of lieberkuhn.
Carcinoid tumour usually presented
with polypoidal growth. In our
case no growth was found. We found
multicentric ileal strictures to our surprise
the resected specimen reported as carcinoid
tumour. Case presentation.60 year
old lady presented with abdominal pain,
recurrent vomiting and clinical examinations
showed visible intestinal peristalsis.
Imaging (X ray, barium meal follow
through,USG) showed dilated small
bowel loops, probable obstruction at the
level of ileum. By this clinical scenario we
proceeded with diagnostic laparoscopy
and found two ileal strictures and liver
found normal. Converted to open laparotomy
and resection anastomosis of the
involved small bowel was done
HPE of the resected bowel showed typical
Carcinoid tumour. We presented this case
for its-1.Rarity of the disease 2.Rarity of the
presentation (carcinoid tumour causing
stricture and small bowel obstruction). 3.
Multicentricity.Conclusion.Literature revealed
that midgut carcinoid presented with
either obstruction or carcinoid syndrome.
Obstruction of small bowel usually due to
polipoidal growth either due to intussuception
or mesenteric ischemia.And no cases
has been reported in any literature that carcinoid
tumour causing stricture of the small
bowel causing obstruction.


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