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CASE REPORT
Intestinal obstruction caused by small bowel adenocarcinoma misdiagnosed as psychogenic disorder
  1. Hirotada Nishie,
  2. Taketo Suzuki,
  3. Hiroshi Ichikawa and
  4. Hiromi Kataoka
  1. Departments of Gastroenterology and Metabolism, Nagoya City University, Nagoya, Japan
  1. Correspondence to Dr Hirotada Nishie, nishix589998{at}yahoo.co.jp

Abstract

We describe a case of intestinal obstruction caused by a small bowel adenocarcinoma misdiagnosed as psychogenic disorder. A woman in her 40s was admitted to Nagoya City University Hospital with fatigue, anorexia, nausea and vomiting. CT, oesophagogastroduodenoscopy and colonoscopy revealed no signs of organic abnormality in her gastrointestinal tract. As the patient had previously been diagnosed with and treated for depression, her symptoms were suspected to be due to psychogenic disorder. Therefore, she was diagnosed with severe depression and was administered antidepressant agents. Despite intense psychiatric treatment, her symptoms worsened and she was later diagnosed with ileus due to adenocarcinoma in the jejunum. After drainage by insertion of a transnasal decompression tube, a partial jejunum resection was performed. After the resection, the patient’s symptoms including fatigue and depression resolved without the use of antidepressant agents.

  • small intestine
  • depressive disorder
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Footnotes

  • Contributors HN has charge of the patient’s history taking and drafting the article. HI and TS have charge of the arrangement of the examinations including enteroclysis and double-balloon enteroscopy. HK is the head of our department. We gather everyone together and argue about the patient to achieve a correct diagnosis. He also had final approval of the article to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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