Background: Small bowel adenocarcinoma (SBA) is a rare but dreaded complication of Crohn's disease with a poor prognosis. The evidence has concluded that it is difficult to differentiate between SBA and benign strictures. Intraoperative and pathological diagnosis is the mainstay of treatment. Case presentation: The current case involves a 40-year-old male with a 12-year history of Crohn's disease who presented with symptoms of small bowel obstruction, which were confirmed by an abdominal C.T. scan. An exploratory laparotomy revealed a stricture, which raised the possibility of malignant disease. Histology revealed a well-differentiated adenocarcinoma. Conclusion: The rarity of small bowel adenocarcinoma in Crohn's disease patients necessitates a high index of suspicion in patients presenting with features of small bowel obstruction or strictures.

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