Ileum adenocarcinoma (IA), a type of small bowel adenocarcinoma, is a rather uncommon factor associated with obstruction in small bowel. Owing to its location and indefinite clinical symptoms, the diagnosis of IA is difficult, and survival is usually poor. With respect to the rarity of this disease, very few studies have reported such cases to provide a reference for treatment.

In this manuscript, a case of a 48-year-old man presented with chronic right lower abdominal pain and distention, queasiness and emesis. A computed tomography scan revealed intestinal wall thickening and an intestinal obstruction in the terminal ileum. He was diagnosed with inflammatory bowel disease. However, his symptoms were not relieved after conservative treatment. The patient subsequently underwent exploratory laparotomy, and a tumour in the ileum measuring approximately 2.0 cm × 2.0 cm that was located 20 cm from the ileocolic valve was discovered incidentally and was operatively resected along with the enlarged lymph nodes. Pathological examination revealed a stage IIA (T3N0M0) ulcerative IA. Along with imaging examinations, a diagnosis of primary IA with no lymph or distant metastases was considered. The patient was discharged and recovered well as of the writing of this manuscript.

IA should be considered as a differential diagnosis in cases of intestinal obstruction, and the recommended method for local disease treatment is surgery.

• Intestinal obstruction
• Ileum adenocarcinoma
• Exploratory laparotomy
• Diagnosis
• Therapy
• Case report

• gastrointestinal bleeding
• gi endoscopy
• hospital readmission
• inpatient care
• small bowel capsule endoscopy

• Capsule endoscopy
• Endoscopic score
• Gastrointestinal bleeding
• Small bowel
• Small bowel bleeding

• Humans
• Capsule Endoscopy
• Female
• Male
• Middle Aged
• Gastrointestinal Hemorrhage/diagnosis
• Aged
• Retrospective Studies
• Intestine, Small/pathology
• Intestine, Small/diagnostic imaging
• Adult
• Predictive Value of Tests

Intestinal motility may be different in obese and nonobese patients, but this has not been determined. Here, we sought to evaluate the effect of obesity on small bowel capsule endoscopy (SBCE). Patients and Methods. We retrospectively analyzed the cases of the 340 patients who underwent SBCE for small intestinal disease (excluding cases of unobservable total small bowel, small bowel stenosis, and bowel resection) at our hospital during the period January 2014 to December 2020 to extract patient background factors and the bowel transit times of SBCE according to the presence/absence of obesity (defined as a body mass index (BMI) ≥ 25 kg/m²).

The obese group was 54 patients (nonobese, n = 286). The small bowel transit time (SBTT) was significantly shorter in the obese patients compared to the nonobese patients (p = 0.0026), and when we divided the patients by their short/long SBTTs using 216.5 min as the cutoff, we observed significant between-group differences in the patients' age (≥60 years) and in the patients' hospitalization status at the time of the SBCE examination. A multivariate analysis revealed that hospitalized status at the examination is a factor contributing significantly to a long SBTT (OR 0.25, 95% CI: 0.15–0.42, p < 0.0001). An analysis using the outpatient/inpatient conditions showed that obesity was an independent factor in the inpatient status at the SBCE examination with a significant short SBTT (OR 2.91, 95% CI: 1.06–7.97, p = 0.0380). Constipation at the examination was also a factor contributing to a long SBTT (OR 0.26, 95% CI: 0.07–0.99, p = 0.0493).

The SBTT of the SBCE was significantly shorter in the obese patients. This tendency was especially evident in the hospitalized state.