A 3 year old boy was brought to the hospital with a three week history of a palpable mass in his right lower quadrant. He was also having abdominal pain, abdominal distention, vomiting and some bloody stool. On exam, he appeared otherwise healthy, but had a distended abdomen with a mass felt in the lower abdomen. The ultrasound showed the mass to be nearly 9cm x 10cm. It appeared to have bowel contents traveling through it.
I wasn’t sure if the mass would be something that I could remove, but since the patient was demonstrating symptoms of a bowel obstruction, I decided to take him to the operating room for an exploration.
At operation, the mass was found in the mesentery of the ileum (last portion of the small intestines). It appeared to be enveloping the end of the small intestines without completely obstructing it. I decided to remove the last portion of the small intestines and the first part of the colon (cecum) and to reconnect the small bowel to the colon by sewing them together.
The patient recovered well. We sent his specimen to a pathologist in country. The examination revealed Non-Hodgkins Lymphoma consistent with Burkitt’s lymphoma. However, after encouraging the mother to bring the patient to the oncologist, she refused on account of lack of finances.