Feifei Shang and Lei Li
Small bowel adenocarcinoma is a very rare disease. Diagnosis is often delayed due to its rarity and nonspecific early symptoms. New diagnostic tools such as CT, NMR, capsule endoscopy and small bowel endoscopy may facilitate its diagnosis. We reported a primary ileum adenocarcinoma clinically presented as chronic fatigue and anemia with occult gastrointestinal (GI) bleeding, complicated with concurrent gastritis and colon polyp. The exploratory laparotomy was required to arrive at diagnosis. Preoperative contrast enhanced CT scan and NMR enterography revealed involved lymph nodes with no clear findings indicating the nature or origin of the lesion.