Adenocarcinoma of the appendix presenting as chronic small bowel obstruction: A case report

Appendiceal carcinoma, a rare malignancy comprising less than 1% of gastrointestinal cancers, often presents diagnostic challenges due to its atypical symptoms. This report details a 68-year-old female with a history of severe anemia, gastrointestinal bleeding, and persistent abdominal symptoms, ultimately diagnosed with chronic small bowel obstruction caused by an appendiceal adenocarcinoma. Despite initial treatment for Helicobacter pylori-induced gastritis, her symptoms persisted, prompting further imaging that revealed a narrowed small bowel segment. Exploratory laparotomy uncovered a stricturing tumor 2 meters from the duodenojejunal junction, leading to en bloc resection of the tumor, appendix, and part of the lateral abdominal wall. Histopathology confirmed moderately differentiated adenocarcinoma. A multidisciplinary team recommended a complete right hemicolectomy, successfully performed despite extensive adhesions and a mesenteric abscess. Postoperatively, the patient recovered well, with ongoing management for anemia and close surveillance. This case highlights the importance of considering rare malignancies in differential diagnoses for chronic small bowel obstruction.