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Peritoneal mesothelioma presenting as an acute surgical abdomen due to jejunal perforation

Nikolaos S Salemis1, Evangelos Tsiambas, Stavros Gourgiotis

  • 12nd Department of Surgery, 417 Army Veterans General Hospital NIMTS, Athens, Greece. nikos_salemis@hotmail.com

Journal of Digestive Diseases
|November 1, 2007
PubMed
Abstract

Insights

This case report details a rare instance of acute abdomen caused by jejunal perforation from peritoneal mesothelioma. Small bowel involvement in peritoneal mesothelioma signifies a poor prognosis.

Area of Science:

  • Gastroenterology
  • Oncology
  • Pathology

Background:

  • Peritoneal mesothelioma is a rare cancer with a poor prognosis.
  • Acute abdomen as an initial presentation of peritoneal mesothelioma is exceptionally uncommon.
  • This report highlights a unique case of jejunal perforation caused by peritoneal mesothelioma infiltration.

Observation:

  • A 62-year-old male presented with peritonitis.
  • CT scans revealed a distal mass to the ligament of Treitz, mesenteric thickening, and ascites.
  • Laparotomy confirmed a perforated tumor with diffuse peritoneal disease.

Findings:

  • Histopathology and immunohistochemistry confirmed malignant mesothelioma infiltration of the jejunum.
  • The patient was diagnosed with pleural mesothelioma postoperatively.
  • The patient succumbed to disseminated disease seven months after surgery despite chemotherapy.

Implications:

  • This case represents the first reported instance of small bowel perforation due to direct peritoneal mesothelioma infiltration.
  • Small bowel involvement is a critical indicator of poor prognosis in peritoneal mesothelioma.
  • This emphasizes the need for vigilance in diagnosing rare presentations of peritoneal mesothelioma.

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