Carcinoid tumors of the terminal ileum simulating Crohn’s disease

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Four patients had carcinoid tumors of the terminal ileum but were diagnosed as having Crohn’s disease and treated for one to four years. The true diagnosis was made only at laparotomy when intestinal obstruction necessitated surgery. Metastasis was present in three cases, and two patients died of metastatic disease. Several diseases other than Crohn’s disease may involve the terminal ileum and produce both clinically and radiologically similar features. Differential diagnostic criteria are discussed. Close follow-up, including carefully performed small bowel series with particular attention to the technical and interpretative details, will help avoid misdiagnosis. If the diagnosis is in doubt, there should be no hestitation to recommend a laparotomy.



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