STRICTURE CAUSED BY CARCINOID TUMOUR, PRESENTED AS SMALL BOWEL OBSTRUCTION - A CASE REPORT

Background. Neuroendocrine tumours (NETs) of the jejunum and ileum are part of a heterogeneous group of gastrointestinal and pancreatic endocrine tumours. Carcinoid tumor arises from enterochromoffin cells at the base of crypts of lieberkuhn. Carcinoid tumour usually presented with polypoidal growth. In our case no growth was found. We found multicentric ileal strictures to our surprise the resected specimen reported as carcinoid tumour. Case presentation.60 year old lady presented with abdominal pain, recurrent vomiting and clinical examinations showed visible intestinal peristalsis. Imaging (X ray, barium meal follow through,USG) showed dilated small bowel loops, probable obstruction at the level of ileum. By this clinical scenario we proceeded with diagnostic laparoscopy and found two ileal strictures and liver found normal. Converted to open laparotomy and resection anastomosis of the involved small bowel was done HPE of the resected bowel showed typical Carcinoid tumour. We presented this case for its-1.Rarity of the disease 2.Rarity of the presentation (carcinoid tumour causing stricture and small bowel obstruction). 3. Multicentricity.Conclusion.Literature revealed that midgut carcinoid presented with either obstruction or carcinoid syndrome. Obstruction of small bowel usually due to polipoidal growth either due to intussuception or mesenteric ischemia.And no cases has been reported in any literature that carcinoid tumour causing stricture of the small bowel causing obstruction.