Metástasis ganglionar mesentérica de neoplasia neuroendocrina: una causa infrecuente de obstrucción de intestino delgado / Small bowel obstruction caused by lymph nodes of a neuroendocrine tumor: a clinical case report

Small intestine neuroendocrine tumors (NET-SI) are relatively rare neoplasms. If encountered, the most common location is the ileum. Symptoms are usually non-specific, delaying the tumors diagnosis. NET-SI are often small in size and can be challenging to recognize on imaging studies. However, they have a tendency to induce a pronounced fibrotic reaction in the mesentery, often accompanied by large calcified mesenteric adenopathies. In some cases, the fibrotic reaction can produce rare complications, such as intestinal obstruction or vascular congestion with occasional secondary ischemia. This case report presents a 79-year-old male with a partial small bowel obstruction caused by a fibrotic reaction and mesenteric adenopathies of a well-differentiated neuroendocrine tumor of the ileum. The patient also presented multiple peritoneal metastases at diagnosis. Characteristic imaging findings of the tumor, allowed an accurate and early diagnosis. Once the acute episode was resolved, the diagnosis was confirmed with an image guided biopsy.

Clinical analysis of 134 patients with ileocecal disease / 重庆医学

Objective To investigate the clinical characteristics and diagnosis and treatment of ileocecal disease.Methods The general data,clinical manifestations,imaging examinations,colonoscopy and pathological examination and diagnosis of 134 patients in our hospital with ileocecal disease from September 2009 to March 2016 were collected.The clinical characters were summarized by retrospective analysis.Results A total of 134 cases with ileocecal disease were collected,and 36(26.87％)of them were ileocecal cancer,30(22.39％)of them were inflammatory bowel disease,26(19.40％)of them were intestinal tuberculosis.The main clinical manifestations of ileocecal lesion were abdominal pain,abdominal distention,diarrhea,bloody stool,etc.The colonoscopy imaging showed mucosal hyperemia,edema,erosion,ulcer and tumors on the intestinal tract.The benign lesions mainly showed ulcer with mucosal erosion and edema,and the ileocecal cancer showed neoplasm.CT examination was the common imaging method,and 93(69.40％)cases got tested.49 cases had operation,in which 7 cases had misdiagnosed before operation,and the rate of misdiagnosis was 14.28％.Conclusion The ileocecal disease is mainly benign lesions,and the process of diagnosis is complex;the rate of misdiagnosis is a little high.

Clinical Characteristics of Lower Gastrointestinal Cancer in Crohn's Disease: Case Series of 5 Patients

Crohn's disease is a chronic inflammatory disease that can involve the entire gastrointestinal tract. Several studies indicate that Crohn's patients with long disease duration have an increased risk of small bowel or colorectal cancer. In Korea, only a few cases of Crohn's disease-related small bowel or colorectal cancer have been reported. Here, we described 3 cases of colorectal cancer and 2 cases of small bowel cancer in patients with Crohn's disease. Among 5 patients, 3 had Crohn's disease-related lower gastrointestinal malignancy and the other 2 had sporadic lower gastrointestinal malignancies. Since the diagnosis of Crohn's disease-related lower gastrointestinal malignancy tends to be delayed, the development of malignancy should be considered in patients with long duration of Crohn's disease if patients have refractory symptoms despite intensive medical treatment. Surgical consultation should not be delayed.

Clinical value of spiral CT in diagnosis of small bowel tumors / 中国基层医药

Objective To explore the clinical vaue of multilayer spiral CT in diagnosis of small intestinal tumor.Methods 36 cases with small intestinal tumor were selected as the research objects,the multi-slice spiral CT imaging results were analyzed retrospectively.Results Sensitivity of multi-slice spiral CT was 94.4％,accuracy of 88.9％.Conclusion Spiral CT is a safe,simple,non-invasive,effective method in diagnosis of small bowel tumors,it has high detection rate.