METACHRONOUS SMALL-BOWEL ADENOCARCINOMA IN CELIAC SPRUE

Celiac sprue, or nontropical sprue, is associated with an increased in cidence of digestive tract malignancy. We report a patient with celiac sprue who developed two primary adenocarcinomas of the jejunum >2 yea rs apart, The second cancer was asymptomatic and detected by surveilla nce computed tomography. Small-bowel cancers are unusual, and frequenc y of follow-up has not been established, so that it is important to ha ve a high index of suspicion for these malignancies in celiac patients with vague gastrointestinal symptoms.