Abstract
Primary gastrointestinal lymphoma is very rare compared to gastrointestinal tract lymphoma arising from secondary to primary nodal disease. Extra nodal lymphoma can involve any part of the gastrointestinal tract, most commonly being the stomach followed by small intestine and ileocecal region. They are indistinguishable from other benign and malignant conditions and are clinically non-specific. While perforation is common among patients undergoing lymphoma treatment, presentation of primary gastrointestinal lymphoma as perforation is rare and needs proper evaluation and management. Here, we describe an interesting case in which a patient presenting with peritonitis was found to have perforation and mass of the jejunum. Resection and anastomosis were performed as intervention, with subsequent histopathological examination showing Malignant Non-Hodgkin lymphoma (NHL). Postoperative follow up was provided along with the appropriate chemotherapy regimen.
Highlights
Acute abdomen signify the need for prompt diagnosis and early treatment, not necessarily always surgical, pain is the main symptom and complaint [1]
Perforated hollow viscus is the perforation of any hollow viscera resulting from inflammatory, infectious, traumatic causes, and neoplasms [2]
The presentation of intestinal lymphoma with perforation occurs at reported frequencies of 1–25%, This perforation can be caused due to complications of chemotherapy [3]
Summary
Acute abdomen signify the need for prompt diagnosis and early treatment, not necessarily always surgical, pain is the main symptom and complaint [1]. The cause of acute abdomen includes perforation hollow viscus, appendicitis, volvulus and acute pancreatitis. Perforated hollow viscus is the perforation of any hollow viscera resulting from inflammatory, infectious, traumatic causes, and neoplasms [2]. In most cases intestinal perforation is discovered only by laparotomy and the definitive diagnosis is available only after histopathologic examination. Lymphoma is a possible but uncommon cause of acute abdomen. The presentation of intestinal lymphoma with perforation occurs at reported frequencies of 1–25%, This perforation can be caused due to complications of chemotherapy [3]. We report the uncommon case of a male suffering peritonitis with Non-Hodgkin Lymphoma located in small intestine and reported the case in accordance to the SCARE 2018 guidelines [4]
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