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Chronic subacute bowel obstruction caused by carcinoid tumour misdiagnosed as irritable bowel syndrome: a case report

机译：类癌肿瘤引起的慢性亚急性肠梗阻误诊为肠易激综合征：一例

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Background Carcinoid tumours are well-differentiated neuroendocrine tumours with secretory properties. Although fairly rare, they are the most common malignancy seen to affect the distal small bowel. Presentation is often non-specific with symptoms mimicking those of irritable bowel syndrome. Given this, the condition is often diagnosed late following disease progression, by which time the prognosis is poor. Case presentation A 74 year old Caucasian lady presented with a two week history of loose stools, nausea and one episode of vomiting. This sub-acute presentation occurred on a background of a four year history of intermittent abdominal pain and bloating, previously diagnosed as irritable bowel syndrome. CT scans identified dilated loops of small bowel proximal to a spiculated mass in the region of the terminal ileum. This ileal lesion was removed at laparotomy and identified as a carcinoid tumour. Conclusion This case highlights the issue of misdiagnosis of intestinal malignancy as the benign condition of irritable bowel syndrome. There have been several other references to this happenstance in the literature, and the problem is reflected in the percentage of patients with widespread disease at the time of diagnosis. Prognosis in this condition can be dramatically improved with early diagnosis, and surgical management at this stage is often curative. For this reason it is imperative to keep this differential diagnosis in the back of one's mind when assessing patients presenting with symptoms of intermittent partial bowel obstruction. The clinical presentation of this tumour, along with investigation and management of these cases, is discussed here.
机译：背景类癌肿瘤是具有分泌特性的分化良好的神经内分泌肿瘤。尽管相当罕见，但它们是影响远端小肠的最常见恶性肿瘤。表现通常是非特异性的，其症状类似于肠易激综合症。鉴于此，通常在疾病进展后才诊断出该病，此时预后较差。病例介绍一名74岁的白​​种女人，有两周便stool，恶心和呕吐史。这种亚急性症状的发生是在四年间断性腹痛和腹胀病史的背景下进行的，以前曾被诊断为肠易激综合症。 CT扫描确定了在回肠末端区域中靠近小块状弥散状的小肠扩张环。该回肠病变在剖腹手术中被切除并被确认为类癌。结论该病例突出了将肠恶性疾病误诊为肠易激综合征的良性疾病的问题。文献中还有其他一些关于这种情况的参考，这个问题反映在诊断时患有广泛疾病的患者中。早期诊断可以大大改善这种情况下的预后，并且在这一阶段的手术​​治疗通常可以治愈。因此，在评估出现间歇性部分肠梗阻症状的患者时，必须将这种鉴别诊断放在脑后。本文讨论了这种肿瘤的临床表现，以及对这些病例的调查和处理。

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