A case of jejunal adenocarcinoma missed at cross-sectional techniques and diagnosed by capsule endoscopy

Abstract

A 50-year-old woman with Lynch syndrome presented to the emergency department with a 1-week history of abdominal pain and vomiting. The patient had undergone recent gastroscopy and colonoscopy, with no pathologic findings. During physical examination she described mesogastric abdominal pain, and laboratory evaluation showed anemia (hemoglobin 8 g/dL). A plain abdominal x-ray revealed mild small-bowel distension and a few air-fluid levels. The patient was admitted for further evaluation. Abdominal CT with contrast medium and CT enterography were performed; neither examination detected pathologic findings except for a single enlarged jejunal mesenteric lymph node (11 × 12 × 12 mm) with moderate contrast enhancement (A).