ILEOCECAL VALVE ADENOCARCINOMA WITH CHRONIC OBSTRUCTION - CASE REPORT

• DOI: 10.22533/at.ed.1592562222099

• Palavras-chave: Adenocarcinoma, ileocecal valve, chronic obstruction

• Keywords: Adenocarcinoma, ileocecal valve, chronic obstruction

• Abstract:

  Intestinal obstruction is a frequent finding during the anamnesis of patients with colonic neoplasms, and sometimes the course of the disease becomes prolonged and the diagnostic opportunity is lost. In these situations, especially in the case of the ileocecal region, the involvement of the surroundings requires a broader approach, which includes the dissection of structures, as well as the performance of lymphadenectomy. Clinical case: female patient, 65 years old, came to the emergency room with signs of arterial hypotension and tachycardia, reporting severe abdominal pain in the lower right quadrant, starting seven days ago, associated with paradoxical diarrhea. He denied fever or weight loss. Comorbidities: systemic arterial hypertension and diabetes mellitus. Imaging exams: An abdominal computed tomography was performed, where the presence of a mass in the ileocecal topography, compatible with the patient's symptoms, was verified. Surgery: the ileocecal valve lesion was addressed by exploratory laparotomy, which included the performance of retroperitoneal lymphadenectomy. The duodenal arch, angle of Treitz and right ureter were dissected, as well as the superior mesenteric vein so that all lymph nodes of the 14V chain were resected. The specimen was sent for histopathological study, and the presence of adenocarcinoma was identified. The patient had a favorable postoperative evolution, with no intercurrences.