Pseudogastroparesis as a presentation of small-bowel malignancy

Establishing the diagnosis of small-bowel malignancy is sometimes an extrem ely difficult challenge owing to its non-specific symptoms. The mainstay of treatment is early recognition, diagnosis and surgical resection. The prog nosis depends primarily on the degree of spread and stage at presentation. We present two cases with initially obscure presentations of a small-bowel tumour. One was a jejunal adenocarcinoma, but an initial upper gastrointest inal and small-bowel series did not disclose the lesion; the other was a pr imary ileal lymphoma, first thought to be diabetes mellitus gastroparesis. Therefore, a negative small-bowel series or presentation of a systemic dise ase-associated intestinal pseudo-obstruction or gastroparesis does not excl ude the possibility of a small-bowel malignancy, if the clinical symptoms a re not alleviated after prokinetic medications. The clinicians should furth er pursue the possibility of an obstructing lesion. Eur J Gastroenterol Hep atol 12:351-355 (C) 2000 Lippincott Williams & Wilkins.