Perforated Primary Small Bowel Lymphoma: A Case Report

Malignant tumors of the small bowel are rarely seen and are usually diagnosed in advanced stages because of the difficulties in diagnosis. Lymphomas account for %1 of malignant gastrointestinal system tumors. Primary gastrointestinal lymphoma is very rare and its preoperative diagnosis is difficult. Its diagnosis is usually made through laparotomy. A 77-year-old male patient developed acute abdomen during observation for partial mechanic intestinal obstruction. Emergent explorative laparotomy revealed perforation of a small bowel tumor. A wide small bowel resection was performed with a double-layer end-to-end anastomosis. Histopathological examination of the surgical specimen was reported as indolent B-cell nonandash;Hodgkina#39;s lymphoma. It should be kept in mind that small bowel tumors can present as mechanic intestinal obstruction, resulting in delayed diagnosis. Turkish Baslik: Perfore Primer Ince Bagirsak Lenfomasi: Olgu Sunumu Anahtar Kelimeler: Bagirsak neoplazileri/cerrahi; lenfoma, non-Hodgkin/cerrahi Ince bagirsak malign tumorleri nadir gorulen ve tani asamasindaki guclukler nedeniyle ileri evrelerde tani konan tumorlerdir. Lenfoma gastrointestinal sistem malign tumorlerinin %1a#39;ini olusturur. Primer gastrointestinal lenfoma ender gorulur ve ameliyat oncesi tani konmasi oldukca zordur. Primer gastrointestinal lenfoma tanisi genellikle laparotomi ile konur. Bu yazida, subileus tanisi ile takip edilmekteyken akut karin klinigi gelisen ve acil cerrahi eksplorasyona alinarak ince bagirsak tumor perforasyonu saptanan 77 yasinda erkek hasta sunuldu. Hastaya genis ince bagirsak rezeksiyonu ve uc uca cift kat ince bagirsak anastomozu yapildi. Histopatolojik inceleme sonucu indolent B-hucreli non-Hodgkin lenfoma olarak bildirildi. Ince bagirsak tumorlerinin nadiren subileus tablosu ile karsimiza cikabilecegi ve taninin cogu zaman gecikebilecegi unutulmamalidir.