Highlights
We present a case of a small bowel adenocarcinoma at an advanced stage, following surgery and adjuvant therapy for colorectal adenocarcinoma, with an atypical presentation at the emergency room, as a rare cause of obstructive small bowel intussusception.
After a successful removal of a carcinoma in the large bowel, there is a higher risk for developing a further primary (metachronous) large bowel tumor. However metachronous carcinomas affecting small bowel are rarer.
Small Bowel adenocarcinoma (SBA) is a rare malignant neoplasm without specific signs and symptoms, and associated with late stage disease presentations.
Patients who develop a small or large bowel adenocarcinoma are at high risk for a second cancer at both sites. However data available to guide therapeutic decisions for those presenting one at small bowel are scarce, and the role of adjuvant therapy in patients who undergo curative resection is unclear.
Studies about strategies for detection at an earlier stage, optimal treatment and prognosis are mandatory for this disease.
Omental infarction is a rare cause of acute abdominal pain. Cases. The report is based on two cases who attended to emergency, complaining of abdominal pain with CT diagnosis of omental infarction. We present a case of a 42 years old man who consulted to the emergency service for a pain in the right hemiabdomen, with elevated inflammatory markers in blood tests. Radiological examination by abdominal CT showed an omental torsion infarction. The patient evolved favourably with conservative treatment. The second case is a 85 years old man appendectomized who consulted for a pain in the left iliac foza with physical examination and complementary and radiological, it is concluded that it is an omental infarction, with a good evolution due to the treatment. Discussion. Clinical diagnosis remains a challenge, due to its rarity and clinical presentation mimicking acute appendicitis or cholecystitis. Hence in the absence of imaging test, intraoperative diagnosis takes place. It can occur due to two main pathogenic mechanisms: Secondary to vascular pedicle torsion (primary or secondary to another abdominal pathology) or situations that predispose to thrombosis. Conclusion. Omental infarction should be considered in the differential diagnosis of acute abdominal pain. Once confirmed by CT abdominal scan, conservative treatment could be considered, avoiding unnecessary surgery.
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