Perforated Small Bowel Adenocarcinoma: An Interesting Presentation of a Rare Disease

Primary small bowel adenocarcinoma (SBA) is a rare disease with no clear guidelines on screening, diagnosis, or treatment. It has been associated with hereditary cancer syndromes; however, most cases are sporadic and frequently associated with inflammatory bowel disease. We present the case of a 43-year-old male who presented with abdominal pain, nausea, and vomiting and was initially diagnosed with a Crohn's disease flare. He subsequently developed a small bowel perforation and was taken to the operating room for resection of the inflamed segment of the ileum; this was later found to be secondary to an obstructing small bowel adenocarcinoma. He developed an anastomotic leak, which mandated re-exploration and allowed for the completion of an oncologic resection. Small bowel adenocarcinoma is difficult to diagnose and treat due to the absence of clear guidelines and the lack of randomized controlled trials in the setting of a very low incidence.