Abstract
The adenocarcinoma of the small intestine is a rare tumor of all gastrointestinal cancers often occurs on a predisposing ground we report the case of a 40-year-old patient chronic smoker has 1 pack year weaned 2 years ago, alcoholic weaned 5 years ago whose symptomatology dates back to 3 months by the appearance of epigastralgia and vomiting post prandial, Complicated by a high occlusive syndrome made of post prandial vomiting with abdominal pain all evolving in a context of alteration of general state made the patient was addressed to the service of digestive cancer surgery and liver transplantation of CHU Ibn Rochd Casablanca.
 The patient had an abdominal CT scan which showed duodenojejunal distension with incarceration of an undistended loop at the level of the aorto-mesenteric clamp.
 The patient was sent to the operating room in emergency, he underwent a segmental Greco-Resection of 15 cm taking away a jejunal mass under laparoscopy with extra corporal anastomosis latero-lateral jejuno-jejunal with at the exploration one notes the presence of a tumoral mass of 3cm mobile at the level of the 2nd loop jejunal stenosing responsible for a jejunal distension upstream measuring 4cm in diameter.
 The anatomopathological study of the specimen showed a moderately differentiated and invasive adenocarcinoma, classified as pT3N1Mx.
 The postoperative follow-up was marked by a deep venous thrombosis involving the ileo-femoral-popliteal axis of the ilio-femoral-popliteal trunk on day 2 postoperatively, for which the patient was put on low molecular weight Heparin at a curative dose with compression stockings and monitoring.
 The patient had resumed transit in the form of gas on postoperative day 3, with a correct assessment, and was declared discharged on postoperative day 6.
 The patient's file was discussed in a multidisciplinary consultation meeting and the decision was to undergo adjuvant chemotherapy and oesogastroduodal fibroscopy (FOGD) and colonoscopy to look for predisposing diseases.
Highlights
Small bowel Adenocarcinoma is defined by the invasion of neoplastic glandular structures through the muscularis mucosae
We report a case of a 40-year-old patient presenting an occlusive syndrome due to a small bowel adenocarcinoma simulating an aortomesenteric compression syndrome
This is a 40-years-old patient with a history of chronic smoking and alcohol consumption. He experienced epigastralgia and post-prandial vomiting, for which he had undergone an Oeso-gastroduodenal fibroscopy which showed a crenelated aspect of the duodenal mucosa and an erythematous gastritis, the symptomatology worsened after 2 weeks by the onset of an occlusive syndrome leading to postprandial vomiting with abdominal pain, and weight loss
Summary
Small bowel Adenocarcinoma is defined by the invasion of neoplastic glandular structures through the muscularis mucosae. It is a rare tumor accounting for less than 2% of all gastrointestinal cancers [1]. The preferred location is the duodenum followed by the jejunal and ileal locations [3] These cancers pose a problem of diagnosis because of the absence of specific signs, the diagnosis is often late explaining the high frequency of advanced stages [4]. It is often revealed by melena, abdominal mass and Koenig syndrome or occlusive syndrome [5]. We report a case of a 40-year-old patient presenting an occlusive syndrome due to a small bowel adenocarcinoma simulating an aortomesenteric compression syndrome
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