A 91 years-old male completely independent to perform daily basic activities with previous history of a laparoscopic cholecystectomy (biliary pancreatitis) open appendectomy in the childhood and benign prostatic hyperplasia. He presented to the emergency room due to increase of the intensity of an abdominal pain that started eight months ago, also he had lost 10kg.
The patient was stable with a soft abdomen, blood test revealed microcytic and hypochromic anemia (Hb: 7,9 g/dl – mean corpuscular hemoglobin: 22,3 picograms/cell – mean corpuscular volume: 76,1 femtoliters/cell), other blood cells and tumoral biomarkers were normal.
He was admitted at the internal medicine department for blood transfusion and to complete the study. A gastroscopy and a colonoscopy ruled out mucosal lesions. A CT scan showed a large endolumenal polyp (8cm) at the ileum causing partiall invavination (VID. 1), there were no pathological lymph nodes, liver or lung lesions.
Evaluation by the surgery department conclude that a case of a large polyp of the ileum causing anemia and partial invagination of the gut required surgical treatment.
The patient underwent a laparoscopic assisted resection of the small bowel with mechanical anastomosis, using a total of three trocars. The laparoscopy was useful to locate the tumor and release adhesions from the previous appendectomy allowing the exteriorization of the tumor for its resection.
The procedure was uneventful, accomplishing macroscopic free resection margins.