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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
PubMed
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.

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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.

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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.