ArticleCureus2026
Malignant Small Bowel Obstruction Unveiling Rare High-Grade Serous Ovarian Carcinoma of Mullerian Origin: A Case Report Detailing Diagnosis and Management.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Malignant small bowel obstruction in advanced ovarian carcinoma is uncommon but carries high morbidity; prompt diagnosis and targeted intervention are critical to relieve symptoms and maintain nutrition. This case is distinguished by an isolated obstruction at the third portion of the duodenum without a discrete intraluminal mass, an atypical site and mechanism in recurrent high-grade serous ovarian carcinoma, necessitating a tailored surgical approach. A 61-year-old female with an established diagnosis of high-grade serous ovarian carcinoma presented with acute-onset abdominal distension, nausea, and obstipation. Contrast-enhanced CT with oral contrast was not feasible due to the patient's inability to tolerate oral intake; therefore, non-contrast imaging was obtained, demonstrating marked dilation of the stomach and proximal duodenum with a transition point at the third portion of the duodenum. Endoscopic decompression yielded 1,700 mL of bilious material; no discrete intraluminal lesion was identified, raising suspicion for extrinsic compression. Exploratory laparotomy confirmed peritoneal and mesenteric implants, with biopsy consistent with recurrent high-grade serous carcinoma. Given the absence of a focal intraluminal lesion amenable to stenting and the presence of multifocal extrinsic disease, a surgical bypass was favored over endoscopic palliation to provide more durable symptom relief and maintain enteral nutrition. Operations performed included gastrojejunal bypass and jejunostomy tube placement. Postoperatively, the patient tolerated nasogastric decompression and total parenteral nutrition, successfully transitioning to jejunal feeding. She ultimately resumed oral intake and was discharged home on postoperative day 17, with plans for adjuvant chemotherapy. This case highlights the importance of an interdisciplinary approach, incorporating early imaging, endoscopic evaluation, and individualized surgical decision-making, in managing malignant small bowel obstruction in ovarian cancer. Recognition of atypical obstruction sites and mechanisms can guide appropriate intervention, improving gastrointestinal function and overall quality of life.
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