Pitiakoudis M, Koukourakis M, Giatromanolaki A, Tsaroucha Alexandra K, Polychronidis A, Simopoulos C
Second Department of Surgery, Medical School Democritus University of Thrace, Alexandroupolis, Greece.
Acta Chir Iugosl. 2003;50(2):131-3. doi: 10.2298/aci0302131p.
Carcinoid tumors are slowly growing malignant neoplasms associated with an indolent clinical course. About 60% of such tumors are located within the gastrointestinal tract. We describe an unusual case of small bowel obstruction associated with a carcinoid tumor of the ileum. A 70-year-old woman was presented with abdominal pain, vomiting, and clinical signs of mechanical bowel obstruction. X-ray and CT-scan of the abdomen showed hydroaeric levels and the presence of intraluminal hyperdense "stones", presumably of gallbladder origin. A diagnostic laparotomy revealed that a large part of the terminal ileus was edematous, with prominent evidence of intestinal loop adhesions. The edematous part of the ileum was resected. Incision of the intestinal wall revealed a 2-cm soft mass at 8 cm from the ileocecal valve, where the presence of ten fruit pits obstructed the intestinal cavity. Histopathological examination confirmed the diagnosis of a carcinoid tumor. An interesting case of small-bowel obstruction with a double cause is presented: an ileal carcinoid and fruit pit bezoars. The pathophysiology of the obstruction is discussed.
类癌肿瘤是生长缓慢的恶性肿瘤，临床病程进展缓慢。约60%的此类肿瘤位于胃肠道内。我们描述了一例罕见的与回肠类癌肿瘤相关的小肠梗阻病例。一名70岁女性出现腹痛、呕吐及机械性肠梗阻的临床体征。腹部X线和CT扫描显示有气液平面及腔内高密度“结石”，推测起源于胆囊。诊断性剖腹探查发现回肠末端大部分水肿，有明显的肠袢粘连迹象。切除了水肿的回肠部分。切开肠壁发现距回盲瓣8厘米处有一个2厘米的软肿块，其中有十个果核阻塞肠腔。组织病理学检查确诊为类癌肿瘤。本文呈现了一例由双重原因导致小肠梗阻的有趣病例：回肠类癌和果核粪石。文中讨论了梗阻的病理生理学。
