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BMJ Case Reports 2012; doi:10.1136/bcr.02.2012.5915
  • Unusual association of diseases/symptoms
  • Unusual association of diseases/symptoms

Small bowel adenocarcinoma: a case of atypical CT scan appearance

  1. Mark Taylor2
  1. 1Department of General Surgery, University Hospital of Leicester, Leicester, UK
  2. 2Department of General Surgery, Kettering General Hospital, Kettering, UK
  1. Correspondence to Amar Mohamed Eltweri, amareltweri{at}hotmail.com

A 73-year-old man presented to the surgical assessment unit with recurrent episodes of central abdominal pain and vomiting for 18 months. He has the  past medical history (PMH) of hypertension and has been using his denture for 35 years; he had no past surgical history; he drinks alcohol socially and not a smoker. This patient was investigated for iron deficiency anaemia with upper and lower gastrointestional endoscopy, as the patient had positive faecal occult blood; rectal biopsy showed no sign of inflammation and no evidence of malignancy; blood investigation showed Hb 9.8 g/dl, white cell count 14.8, mean cell volume 86.3, mean cell haemoglobin 26.9 and C reactive protein 13. This patient underwent a CT scan of the chest, abdomen and pelvis; the latest one showed that there is a short segment of the middle part of the small bowel that looks thickened and within which there is a high-density calcified shadow which is reported as an ingested foreign body or a tooth fragment; the patient underwent laparotomy and the histology results revealed 30 mm well differentiated/moderately differentiated adenocarcinoma.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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