Primary adenocarcinoma of small intestine is a rare malignancy constitute <1% of whole abdominal malignancies.Adenocarcinoma of small intestine will rarely produce symptoms until the disease is advanced. Preoperative diagnosis is difficult due to inaccessibility for guided biopsies.Themost frequent presentations are abdominal pain, nausea, vomiting, and weight loss. They may also present with haemorrhage, obstructive symptoms or perforation peritonitis.The low incidence and lack of pathognomonic symptoms make an accurate diagnosis small bowel carcinoma a challenge to the surgeons. In this paper we are reporting a case of ileal adenocarcinoma in a patient who presented withacute abdomen and perforation peritonitis. We are presenting it because of the rarity of the condition.

Keywords: Adenocarcinoma; Carcinoid; Lymphoma; Sarcomas or Gastrointestinal Stromal Tumours (GIST); Laparotomy; Segmental Resection; Chemotherapy; Radiotherapy.