Ulus Travma Acil Cerrahi Derg. 2020; 26(1): 144-147 | DOI: 10.5505/tjtes.2018.42273

Castleman's disease presenting with mechanical intestinal obstruction: A rare case

Abdulcabbar Kartal¹, Eray Atlý², Gürcan Vural³, Murat Ferhat Ferhatoðlu¹, Ali Ýlker Filiz^1
1Department of General Surgery, Okan University Faculty of Medicine, Ýstanbul-Turkey
²Department of Radiology, Okan University Faculty of Medicine, Ýstanbul-Turkey
³Department of Pathology, Okan University Faculty of Medicine, Ýstanbul-Turkey

Castleman’s disease (CD) is a lymphoproliferative disorder and the occurrence of CD in the small bowel is rare. In this study, we present one case of CD causing mechanical intestinal obstruction due to involvement of terminal ileum. A 50-year-old man was admitted to the hospital with signs and symptoms of mechanical intestinal obstruction without history previous surgery. After examination and obtaining abdominal computed tomography, diagnosis of mechanical intestinal obstruction was reached and emergency surgery was performed with a median incision. On abdominal exploration a tumor like mass that also held distal small intestine mesentery, and ileocecal valve causing complet intestinal obstruction was observed. Ileocecal resection and ileocolonic anastomosis were performed. CD is a rare entity and should be kept in mind during the differential diagnosis of mechanical intestinal obstruction provided that wall thickening in terminal ileum mimicking mass, and accompanying enlargement mesenteric lymph nodes observed during preoperative investigations or intraoperative exploration.

Keywords: Castleman’s disease, lymphoproliferative disorder; mechanical intestinal obstruction; mesenteric lymph nodes; terminal ileum.

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Mekanik baðýrsak týkanmasýyla baþvuran Castleman hastalýðý: Nadir bir olgu

Abdulcabbar Kartal¹, Eray Atlý², Gürcan Vural³, Murat Ferhat Ferhatoðlu¹, Ali Ýlker Filiz^1
1Okan Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Ýstanbul
²Okan Üniversitesi Týp Fakültesi, Radyoloji Anabilim Dalý, Ýstanbul
³Okan Üniversitesi Týp Fakültesi, Patoloji Anabilim Dalý, Ýstanbul

Castleman hastalýðý, lenfoproliferatif bir hastalýktýr ve ince baðýrsakta görülmesi nadirdir. Bu çalýþmada, terminal ileum tutulumuna baðlý mekanik baðýrsak týkanýklýðýna neden olan bir Castleman hastalýðý olgusu sunuldu. Daha önce geçirilmiþ karýn cerrahisi öyküsü olmayan 50 yaþýnda erkek hasta, mekanik baðýrsak týkanýklýðý bulgularý ve semptomlarý ile hastaneye baþvurdu. Muayene ve abdominal bilgisayarlý tomografi ile mekanik intestinal obstrüksiyon tanýsý konuldu ve median insizyon ile acil cerrahi giriþim yapýldý. Abdominal eksplorasyonda, distal ince baðýrsak mezenterini ve ileoçekal valvi tutan tümör benzeri kitlesel lezyonun intestinal obstrüksiyona neden olduðu görüldü. Ýleoçekal rezeksiyon ve ileokolik anastomoz yapýldý. Castleman hastalýðý nadir görülen bir durumdur. Görüntülemede ya da ameliyat sýrasýnda büyümüþ lenf bezlerine eþlik eden distal ileumda kitle benzeri görünüm tespit edilmesi durumunda mekanik baðýrsak týkanýklýðýnýn ayýrýcý tanýsýnda akýlda bulundurulmalýdýr.

Anahtar Kelimeler: Castleman hastalýðý, lenfoproliferatif bozukluk; mekanik intestinal obstrüksiyon; mezenterik lenf nodlarý; terminal ileum.

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