duodenal adenocarcinoma might be the cause of intractable nausea and vomiting in patient with coeliac disease

coeliac disease (cd) is an autoimmune disorder which leads to chronic inflammation of the gut. untreated cd is associated with upper gastrointestinal malignancies, small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (cd). we report the case of a 43-year-old male suffering from cd who was treated with a gluten-free diet one year,  presenting with complaints of intractable nausea and vomiting. after several studies, he underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. however, histopathological examination showed adenocarcinoma. subsequently, a duodenal segment resection was performed. after surgery, the patient recovered well and left our hospital in good condition. clinicians should take into small bowel adenocarcinoma is rare but associated with cd particularly in cd patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy.