PMC4701855_01
Axial CT scan after contrast administration showing wall thickening of the jejunum which was abnormally on the right (red arrow). The tumor was narrowing the jejunal lumen; total obstruction was a result of a bezoar (white arrow). Mesenteric limits of the tumor are ill defined with fat densification (yellow arrow).
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The bowel lumen was completely obstructed by a bezoar (Fig. 1).
A/Axial CT scan after contrast administration, the superior mesenteric vein (blue arrow) lies in front of the superior mesenteric artery (red arrow). Tumor (yellow arrow) extends to proximal jejunum with extension to mesenteric fat. B/Coronal reconstruction of CT scan after aspiration: the caecum is highly situaded in the right flank (arrow). All these findings are consisting with a mesenteric malrotation.
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Treitz angle was at the right side of the abdomen and the superior mesenteric vein was anterior to the superior mesenteric artery (Fig. 2).
Excised tumor specimen.
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During surgery, there was a tumor of the Treitz (Fig. 3).
Histopathologic examination shows a carcinomatous infiltrating lesions which extends from the intestinal mucosa to the subserosal layer.
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The final histopathological diagnosis showed a well differentiated adenocarcinoma of the jejunum with 30% of mucinous component (Fig. 4).