An 11-year-old SF DSH was presented for evaluation of acute vomiting and anorexia with a history of weight loss over 3 months.
An 11-year-old SF DSH was presented for evaluation of acute vomiting and anorexia with a history of weight loss over 3 months.
Ileocecocolic mass, mild regional lymphadenopathy and regional inflammation. Variable small intestinal thickening elsewhere.
Exploratory surgery with aggressive ileocecocolic resection and lymph node removal would be recommended. Adjunctive chemotherapy is likely going to be necessary in this case. The mid intestinal biopsies are also recommended for further definition of the diffuse thickening, which is considered mild in this region. Intraoperative ultrasound would be optimal in this patient in order to adequately resect the infiltrative pattern that the surgeon may not overtly visualize. Primary differentials include intestinal carcinoma, lymphoma or less likely granulomatous disease.
The abdomen revealed an ileocecocolic mass that measured 3.42 x 3.0 cm with variable areas of mixed, hypoechoic changes. Focal areas of mineralization were noted in the ileocecal mass. This is suggestive for carcinoma. Regional lymph nodes were also enlarged measuring approximately 1.0 cm each. Hyperechoic fat was noted adjacent to the mass, which is suggestive for concurrent inflammation. The upper gastrointestinal tract was unremarkable. The distal small intestine was thickened with a 1:1 mucosal to muscularis ratio with some loss of detail. Areas of intestinal wall thickening were noted elsewhere. Therefore, if ileocecocolic resection can be performed, then concurrent intestinal biopsies would be recommended.
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GIT – lymphoma, IBD, partial obstruction, granulomatous disease, non-specific enteritis (viral, bacterial, helminths, protozoal), dietary indiscretion, food hypersensitivity
Pancreatitis
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