Case report of a gastrointestinal tumour (carcinoid tumour): A diagnostic delima

Abstract

Author(s): Okoi Nta Obono, Theophilus Ugbem Ipeh, Akaba Kingsley

Background: Carcinoid tumors are rare gastrointestinal malignancies and are slow growing compared with adenocarcinomas. Because they rarely invade the intestinal mucosa, they are extremely difficult to diagnose. The aim of this case report is to emphasize the difficulty in making a clinical diagnosis of this tumor and require a high index of suspension.

Method: The case records of a 42-year-old widow who present with a history of intermittent profuse diarrhea for one year. Each episode was trigger by eating either Bananas, pineapple, avocado pears or food containing too much of tomatoes and was diagnosed to have ileal carcinoid tumors on laparotomy. A review of literature was done using med line and manual library search.

Results: The patient was admitted in the female ward for 2 days and was treated conservatively with good intravenous fluid of 6 liters of normal saline. She got better and was discharge home. Two weeks later, she came back with similar complain after she ate bananas and pineapple fruit drink. An abdominal ultrasound scan was ordered which was of no use to the diagnosis. An exploratory laparotomy was carried out where a small mass was found located in the medium. Ileal resection and end-to-end anastomosis were done. There was good wound healing and was discharged 12 days after laparotomy. She was well clinically at follow up review one month after discharge.

Conclusion: The case illustrates the difficulty in making a diagnosis and therefore requires a high index of suspicion before surgery.

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