Diagnosing and managing small bowel neuroendocrine tumors presenting as acute obstruction in an elderly patient: A case report and comprehensive management overview

• Published in: International journal of surgery case reports 2024-09, Vol.122, p.110126, Article 110126
• Main Authors: Behi, Hager, Omry, Ahmed, Dallagi, Rania, Changuel, Amel, Troudi, Dholkefl, Khalifa, Med Bachir
• Format: Article
• Language: English
• Subjects: Bowel obstruction; Case report; Follow-up; Neuroendocrine tumor; Small bowel; Surgery
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.110126

Neuroendocrine tumors (NETs) of the small bowel are rare but clinically significant due to their challenging diagnostic pathways and potential for insidious progression. Early identification is critical for effective management and improved prognosis in these cases. Here, we present a case of a 75-year-old patient with no significant medical history who presented acutely with diffuse abdominal pain, vomiting, and signs of bowel obstruction. Diagnostic workup, including CT imaging, revealed a distal ileal neuroendocrine mass with mesenteric lymphadenopathy, necessitating urgent surgical intervention. This case underscores the diagnostic complexities and therapeutic challenges associated with small bowel NETs. Surgical resection with meticulous lymph node dissection remains the cornerstone of treatment, aimed at achieving complete tumor excision and optimal disease control. The role of imaging modalities and biochemical markers in guiding clinical decisions and postoperative management strategies is discussed considering the patient's clinical course. Timely recognition and intervention are crucial in the management of small bowel NETs, given their potential for late presentation and nonspecific symptoms. Despite diagnostic and procedural challenges highlighted in this case, early surgical intervention and comprehensive follow-up are essential for achieving favorable outcomes and minimizing recurrence risks in patients with small bowel NETs. •This case report highlights the challenge of diagnosing small bowel neuroendocrine tumors (SBNETs), which often present with vague and nonspecific symptoms, leading to diagnostic delays.•The case underscores the importance of utilizing urgent imaging, specifically CT scans, in the rapid assessment and management of acute bowel obstructions caused by SBNETs, emphasizing the need for tailored diagnostic approaches based on clinical presentation.•Thorough histopathological evaluation is crucial in diagnosing neuroendocrine tumors, as it provides essential information on tumor grade and metastatic spread, which are critical for guiding postoperative management and determining prognosis.•The case emphasizes the necessity of long-term follow-up and surveillance post-surgery, despite a relatively short follow-up period in this report, to monitor for potential recurrence and ensure optimal patient outcomes.