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[Acute diffuse peritonitis of a rare cause]
D Deceanu1, M Cazacu, M Tudose
1Clinica Chirurgie IV (Spital CFR), U.M.F. Iuliu Haţieganu Cluj-Napoca.
Chirurgia (Bucharest, Romania : 1990)
|October 1, 2004
Summary
This case report details a rare instance of non-Hodgkin lymphoma presenting as acute abdominal pain and peritonitis due to jejunal perforation in an 18-year-old male. The diagnosis was diffuse large B-cell lymphoma, highlighting a critical consideration for digestive tract lymphomas.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Pathology
Background:
- Non-Hodgkin lymphoma (NHL) can rarely manifest with acute abdominal complications.
- Secondary involvement of the digestive tract by lymphoma can mimic common surgical emergencies.
Observation:
- An 18-year-old male presented with acute abdominal pain, peritonitis, and pneumoperitoneum, initially diagnosed as peptic ulcer perforation.
- Physical examination revealed splenomegaly and cervical lymphadenopathy; ultrasonography confirmed splenomegaly and suggested a gastric tumor.
Findings:
- Surgical exploration identified jejunal perforation secondary to a stenosing tumor, proximal to a gastric tumor, and confirmed splenomegaly.
- Pathological diagnosis confirmed diffuse large B-cell non-Hodgkin lymphoma.
Implications:
- This case underscores the importance of considering lymphoma in young patients with acute abdomen and unexplained splenomegaly or lymphadenopathy.
- Early recognition and diagnosis of secondary digestive tract lymphoma are crucial for appropriate management and therapeutic strategies.