부산대학교 도서관

A 67-year-old man who had undergone open abdominal surgery in childhood presented with chief complaints of abdominal pain and vomiting, and he was admitted as an emergency with a diagnosis of ileus. Although his symptoms improved after decompression with a nasogastric tube, they reappeared repeatedly each time he started eating. Contrast-enhanced computed tomography (CT) showed intestinal stenosis near the ileocecal junction, and in view of the limited effectiveness of decompression treatment, it was decided to perform elective surgery. An attempt was made to remove the intestinal obstruction laparoscopically, but due to widespread adhesions between the lateral abdominal wall and the small intestine and between different parts of the small intestine in the right lower abdomen, the procedure was converted to open surgery. The small intestine formed a single edematous mass containing multiple white nodules on the mesenteric side of the ileal wall, which were suspected to be malignancies causing stenosis. A 22-cm portion of the terminal ileum was resected, including as many of the lesions as possible. Pathological examination showed 9 nodules, mainly in the submucosa of the small intestinal wall, and grade 1 neuroendocrine tumor (NET) was diagnosed. Small intestinal NET is uncommon in Japan, and there have been few reported cases of the discovery of multiple lesions during surgery for intestinal obstruction. This condition was formerly known as “carcinoid,” and this case is reported together with a review of the literature of cases of small intestinal carcinoid and NET.