[Primary ileal carcinoma]

Recently encountered is a case of a primary ileal carcinoma in which radical resection was performed. The history follows. A 76-year-old male was admitted to Miyako Hospital on January 12, 1986 complaining of abdominal pain of ten days duration. Pre-operative treatment extended over an eleven-day period without any symptomatic remission. A barium enema and roentgenographic examination that followed a barium ingestion revealed no abnormality in the large bowel, but a mechanical obstruction, typical of a carcinoma, was detected in the small intestine. On January 23, 1986, under a general anesthesia, the abdomen was opened through a midline rectus incision. A tumor was found in the terminal ileum 14 cm proximal to the ileocecal valve, and was causing almost total obstruction of the intestine. This tumor, with involved ileal and regional lymph-nodes, was resected, followed by an end-to-end anastomosis. The tumor, grossly circumscribed, was roughly circular in outline and protruded from the ileal wall. No lymph-node metastasis was found in histological sections. The diagnosis was a primary adenocarcinoma of the ileum. Few reports have been reported in Japan on radically resected primary carcinomas of the ileum. The future course of this case deserves careful study.