Acute small bowel obstruction revealing a rare localization of lymphoma: a case report

Introduction: Acute small bowel obstruction (SBO) is a common surgical emergency, often caused by abdominal adhesions. However, tumors, particularly gastrointestinal lymphomas, can also lead to SBO. Although rare, lymphomas present distinct diagnostic and therapeutic challenges. This report discusses a case of SBO secondary to diffuse large B-cell lymphoma (DLBCL). Case presentation: A 40-year-old man with no significant medical history presented with progressive abdominal pain and SBO. Computed tomography imaging revealed circumferential stenosis in the terminal ileum, and surgical exploration identified a 5 cm tumor. The patient underwent a right hemicolectomy including resection of the last two ileal loops, followed by an ileocolostomy. Histopathology confirmed DLBCL, and the patient received postoperative chemotherapy and immunotherapy. He was disease free at 1-year follow-up. Discussion: Gastrointestinal lymphomas, though uncommon, typically affect the stomach and small intestine. They present with nonspecific symptoms like abdominal pain and malnutrition. Radiologically, circumferential wall thickening may mimic other conditions, complicating diagnosis. Diagnosis relies on histopathology, while staging guides treatment, which may include surgery, chemotherapy, and immunotherapy. Conclusion: Gastrointestinal lymphoma should be considered in SBO cases. Accurate diagnosis via histopathology and immunohistochemistry is crucial for treatment planning. Multidisciplinary management, including surgery and chemotherapy, is key to improving patient outcomes.