Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8090
Peer-review started: September 3, 2017
First decision: September 21, 2017
Revised: October 5, 2017
Accepted: October 26, 2017
Article in press: October 26, 2017
Published online: December 7, 2017
Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors, commonly called carcinoids, account for about 2/3 of all neuroendocrine tumors, they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms, which usually leads to a delayed diagnosis. Imaging modalities can aid diagnosis and surgery remains the mainstay of treatment. We present a case of a jejunal neuroendocrine tumor that caused nonspecific symptoms for about 1 year before manifesting with acute mesenteric ischemia. Abdominal X-rays revealed pneumatosis intestinalis and an abdominal ultrasound and computed tomography confirmed the diagnosis. The patient was submitted to segmental enterectomy. Histopathological study demonstrated a neuroendocrine tumor with perineural and arterial infiltration and lymph node metastasis. The postoperative course was uneventful and the patient denied any adjuvant treatment.
Core tip: The current case report underlines the indolent clinical course with nonspecific symptoms of a small intestine carcinoid that finally caused acute intestinal ischemia. This case also emphasizes the importance of simple imaging modalities, such as X-rays and the abdominal sonography, in the work-up of a patient with intestinal ischemia.