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Small bowel tumors are very cancers. The clinical presentation is not specific. High suspicion is necessary when small bowel obstruction is seen in elderly patients. Most commonly it presents with symptoms of nausea vomiting and weight loss. Cancers can arise from the lining of the small bowel called the mucosa or lympho neurovascular bundle. There are various types of cancers that affect the small bowel. Here we discuss a case of a young adult male who presented nausea vomiting and weight loss.
Small bowel tumors are a very rare condition. The tumors may arise from various components of the small bowel wall. It may arise from the mucosa or from the neuro lymphovascular bundle. The presentation varies, patients may have non-specific weight loss, asthenia, or some nausea in the early stages. Some patients when the disease has progressed can have symptoms of abdominal pain, nausea vomiting with occasional bleeding, or anemia. There has been a tremendous leap in the diagnosis, staging, and management of small bowel tumors in the last two decades attributed to a better insight into its etiology and molecular knowledge.
Primary gastrointestinal lymphoma, however, is very rare, constituting only about 1%-4% of all gastrointestinal malignancies. Gastrointestinal lymphoma is usually secondary to widespread nodal diseases. Here our patient was seen and evaluated by MH Surgery Clinic surgeons for nonspecific symptoms.
During the evaluation, he was found to be in weight loss and anemia. He was evaluated and further investigations were performed. He also had abdominal distension and pain started to increase. He was managed by our surgeons at Surgical Gastroenterology Center in MH Surgery Clinic. He underwent a high-resolution computed tomography scan of the abdomen which confirmed a small bowel tumor more likely lymphoma. He developed closed-loop small bowel obstruction due to the tumor. He was immediately offered surgery. He was investigated before the complex GI surgery. All this was only possible after a careful and close evaluation of the investigations by MH Surgery Clinic Surgeons.
During the surgery, there was a large area of the tumor that had occupied nearly 30cm of the small bowel. The small bowel was resected and the diagnosis was confirmed. All this was performed via a Minimally Invasive Advanced Surgery technique. The patient recovered extremely well and remained insignificant low pain and was discharged home in three days.
In many patients, this diagnosis is not clearly identified or explained in detail to the patient. Some patients may develop diffuse disease and this can be an issue. He was later seen and evaluated by a medical oncologist for future chemotherapy. All cases need careful evaluation and management. The patient presentation can be variable. Patients require careful evaluation and surgical correction which is available at Surgical Gastroenterology Center in MH Surgery Clinic.