{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:53:50Z","timestamp":1790272430096,"version":"4.1.0"},"reference-count":13,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,7]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:p>Adenocarcinoma of the bowel is a dreadful sequelae of inflammatory bowel disease that can be difficult to diagnose and has been shown to have poor prognosis. The diagnosis is often made on histopathological examination of the resected specimen for what is suspected to be an exacerbation of the underlying intestinal Crohn\u2019s. A 39-year-old woman who was being treated for small bowel Crohn\u2019s disease for 4\u2009years presented with features of intermittent intestinal obstruction that was refractory to medical therapy. A contrast CT of the abdomen was suggestive of ileocaecal Crohn\u2019s disease, and colonoscopy revealed a stricture at proximal transverse colon with multiple superficial ulcers. She underwent a mesentery sparing right hemicolectomy and had an uneventful recovery. The biopsy, however, was reported to be moderately differentiated adenocarcinoma stage T3N0 with a harvest of four pericolic nodes. Adjuvant chemotherapy was advised, which she deferred. Ten months later, she presented to the emergency room with features of intestinal obstruction. Contrast CT of the abdomen showed thickening at the anastomotic site with intestinal obstruction. On exploratory laparotomy, tumour recurrence was noted at the site of the anastomosis and diffuse peritoneal metastasis. A palliative diversion ileostomy was done due to inoperable obstructing disease. She was then given palliative therapy and subsequently succumbed to the illness. The inclusion of mesentery with the resected specimen in Crohn\u2019s disease has been a debate over many years. Since the preoperative diagnosis of carcinoma of the bowel in Crohn\u2019s disease is challenging, all ileocolic resections should be radical as done in oncological resections. This would yield better oncological safety and may improve survival rates.<\/jats:p>","DOI":"10.1136\/bcr-2020-234512","type":"journal-article","created":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T07:06:33Z","timestamp":1587107193000},"page":"e234512","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Crohn\u2019s disease associated adenocarcinoma of ileocaecal region: a miscalculated approach"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6733-9189","authenticated-orcid":false,"given":"Royson","family":"Dsouza","sequence":"first","affiliation":[{"name":"Department of General Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gigi","family":"Varghese","sequence":"additional","affiliation":[{"name":"Department of General Surgery & Colorectal Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa Rebecca","family":"Korula","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit Kumar","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"2025082707150675000_13.4.e234512.1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i33.11486"},{"key":"2025082707150675000_13.4.e234512.2","first-page":"343","article-title":"Adenocarcinoma of the small intestine in Crohn's disease","volume":"173","author":"Ribeiro","year":"1991","journal-title":"Surg Gynecol Obstet"},{"key":"2025082707150675000_13.4.e234512.3","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0848-z"},{"key":"2025082707150675000_13.4.e234512.4","first-page":"227","article-title":"Cancer in inflammatory bowel disease","volume":"67","author":"Greenstein","year":"2000","journal-title":"Mt Sinai J Med"},{"key":"2025082707150675000_13.4.e234512.5","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.150.3.6695061"},{"key":"2025082707150675000_13.4.e234512.6","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1177\/000313480707301122","article-title":"Small bowel adenocarcinoma complicating Crohn's disease: case series and review of the literature","volume":"73","author":"Dossett","year":"2007","journal-title":"Am Surg"},{"key":"2025082707150675000_13.4.e234512.7","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/S2468-1253(16)30026-7","article-title":"The mesentery: structure, function, and role in disease","volume":"1","author":"Coffey","year":"2016","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025082707150675000_13.4.e234512.8","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1038\/nrgastro.2016.40","article-title":"Colorectal cancer: surgery for colorectal cancer - standardization required","volume":"13","author":"Coffey","year":"2016","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2025082707150675000_13.4.e234512.9","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21413"},{"key":"2025082707150675000_13.4.e234512.10","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/j.1365-2249.2012.04660.x","article-title":"Serum levels and mesenteric fat tissue expression of adiponectin and leptin in patients with Crohn's disease","volume":"170","author":"Rodrigues","year":"2012","journal-title":"Clin Exp Immunol"},{"key":"2025082707150675000_13.4.e234512.11","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1093\/ecco-jcc\/jjx187","article-title":"Inclusion of the mesentery in ileocolic resection for Crohn\u2019s disease is associated with reduced surgical recurrence","volume":"12","author":"Coffey","year":"2018","journal-title":"J Crohn\u2019s Colitis"},{"key":"2025082707150675000_13.4.e234512.12","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20393"},{"key":"2025082707150675000_13.4.e234512.13","doi-asserted-by":"crossref","unstructured":"Li Y , Mohan H , Lan N , et al . Mesenteric excision surgery or conservative limited resection in Crohn\u2019s disease: study protocol for an international, multicenter, randomized controlled trial. Trials 2020;21.doi:10.1186\/s13063-020-4105-x","DOI":"10.1186\/s13063-020-4105-x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-234512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:15:16Z","timestamp":1756304116000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-234512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":13,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4,16]]},"published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1136\/bcr-2020-234512"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-234512","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4]]}}}