Small Bowel Adenocarcinoma in Association with Ulcerative Colitis: A Case Report

Abstract

We herein report a case of small bowel carcinoma associated with ulcerative colitis (UC). The patient was a 42-year-old male patient who had been diagnosed with and treated for UC since 18 years earlier but he interrupted medical treatment by his own decision. This time he was brought into our hospital by ambulance because of the abrupt onset of severe abdominal pain. There was muscular defense mainly around the navel. Peritonitis caused by gastrointestinal perforation was diagnosed and an emergency operation was carried out. Upon laparotomy, we found a 5-cm diameter tumor as well as perforation at a portion of the small intestine 20 cm proximal to the ileocecal region, and then performed small bowel resection and ileostomy. Histopathology of the resected specimen revealed inflammatory findings on the ileal mucosa and adenocarcinoma. Colonoscopy performed after the surgery identified UC involving the entire colon.
Our experience suggests that long-term UC with backwash ileitis could be the cause of small bowel adenocarcinoma. We present details of clinic-pathological characteristics of this rare case and review the literature.