A case of perforation of a small bowel lymphoma in a patient with coeliac disease is reported. Postoperative management was complicated by a large protein and fluid loss from the small bowel, rapidly controlled by treatment with corticosteroids. Attention is drawn, by briefly reviewing 11 other cases, to the ways in which small bowel lymphoma in patients with coeliac disease may present to the surgeon. Most patients who develop this complication of coeliac disease will die within 6 months of the diagnosis of small bowel lymphoma. Attention is drawn in this case to the rapidity with which the tumour grew and became disseminated.
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