{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:56:15Z","timestamp":1785873375627,"version":"3.56.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>The most common cancer among females worldwide and in Saudi Arabia is breast cancer. Lobular breast carcinoma is the second most common subtype of breast cancer. There are different patterns of metastasis as ductal breast cancer spreads to the liver, lung, brain, and bone while the lobular subtype metastasizes to the gastrointestinal tract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 69-year-old Indian pilgrim presented to the ER complaining of abdominal pain, vomiting, and abdominal distention admitted as a case of intestinal obstruction. CT scan demonstrated intestinal obstruction with transition zone at the terminal ileum. The patient underwent exploratory laparotomy where she was found to have a mass at the terminal ileum. Resection of around 8 cm of small bowel and primary anastomosis were done, histopathology revealed metastatic lobular breast carcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>Patients with metastatic breast cancer to the gastrointestinal tract often present with nonspecific symptoms, while acute cases present with complications such as perforation. In a retrospective review of metastatic breast cancer, the majority metastasizes to the colon and rectum, while 19 % to the small bowel. Palliative surgery is considered the first-line treatment of complicated patients, while stable cases are referred to medical oncology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Breast cancer is the second most common cancer leading to death and lobular subtype has more propensity to metastasize to the gastrointestinal tract compared to ductal breast cancer. Regarding patients presenting to the emergency bay, treating the emergency complaints is the standard management. For immigrant patients, we highly recommend creating a data system for sending histopathology reports to facilitate follow-up in their countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.109855","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T20:17:49Z","timestamp":1717705069000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Small bowel obstruction as first presentation of metastatic lobular breast cancer for pilgrim patient"],"prefix":"10.1097","volume":"120","author":[{"given":"Najmah A.","family":"Alsobahi","sequence":"first","affiliation":[{"name":"General Surgery Senior Registrar, Al-Noor Specialist Hospital, Makkah Health Cluster"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talaat A.","family":"Mohammed","sequence":"additional","affiliation":[{"name":"General Surgery Consultant, King Faisal Hospital, Makkah Health Cluster"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-77-20260325","article-title":"Duodenal obstruction as first presentation of metastatic breast Cancer","volume":"2015","author":"Khairy,","year":"2015","journal-title":"Case Rep Surg."},{"issue":"2","key":"R2-77-20260325","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.crad.2004.09.005","article-title":"Metastatic manifestations of invasive lobular breast carcinoma","volume":"60","author":"Doyle,","year":"2005","journal-title":"Clin. 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Gastroenterol."},{"issue":"1","key":"R8-77-20260325","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1038\/bjc.1984.135","article-title":"A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating duct carcinoma of the breast","volume":"50","author":"Harris,","year":"1984","journal-title":"Br. J. Cancer"},{"issue":"4","key":"R9-77-20260325","first-page":"637","article-title":"Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast","volume":"114","author":"Borst,","year":"1993","journal-title":"Surgery"},{"issue":"6","key":"R10-77-20260325","first-page":"438","article-title":"Breast cancer statistics, 2019","volume":"69","author":"DeSantis,","year":"2019","journal-title":"CA Cancer J. 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