Journal of Clinical and Investigative Surgery
ISSN: 2559-5555


The diagnostic and therapeutic management of a peculiar case of rectal submucosal adenocarcinoma

Angela Blajin1, Dan Cristian1,2, Iulia Sălcianu3, Luminița Welt4, Răzvan V. Scăunaşu1,2, Nicu Berevoescu1,2, Cătălina Blajin2, Traean Burcoş1,2

1Colțea Clinical Hospital, Department of General Surgery, Bucharest, Romania
2Carol Davila University of Medicine and Pharmacy, Faculty of General Medicine, Bucharest, Romania
3Colțea Clinical Hospital, Department of Radiology and Medical Imaging, Bucharest, Romania
4Colțea Clinical Hospital, Department of Pathological Anatomy, Bucharest, Romania

J Clin Invest Surg. 2018; 3(1): 47-52. DOI: 10.25083/2559.5555/31.4752
Running title: A peculiar case of rectal submucosal adenocarcinoma
Keywords: rectal cancer, sclerosing encapsulating peritonitis, chronic obstruction


Introduction. We are presenting the case of a 50 years old female patient with rectal cancer, developed from the submucosal level, who raised difficulties in diagnoses process and therapeutic management.

Case report. The patient’s symptomatology began four months before the definitive diagnose. Various investigations have been performed, including multiple biopsies which were inconclusive. Surgical intervention was performed to obtain definitive malignancy HP result. The postoperative evolution was peculiar, marked by complications, which required multiple surgical interventions.

Conclusions. The development of the adenoma, predominantly at the submucosal and muscular level has caused difficulties in both establishing the diagnosis and in the therapeutic management. Sclerosing encapsulated peritonitis (SEP) is a rare clinical entity, usually discovered in postoperative intestinal obstruction cases. The etiology and frequency of SEP depend on its’ type.