the incidence of neuroendocrine tumors is increasing ( approximately 6% per year ) , but clinical presentation is nonspecific , resulting in delays in diagnosis ( 5 - 7 years ; approximately 70% have metastases ) . neuroendocrine tumors usually exist at the lung , stomach and colon , but the small bowel is a rare location . we present an unusual case of small bowel neuroendocrine malignant tumor diagnosed by double - balloon enteroscopy ( dbe ) . the capsule was stuck in the jejunum stricture and was removed with a snare under dbe . a 36-year - old man with weight loss presented with a 1-year history of distention , abdominal pain and macies . capsule endoscopy found segmental distribution of ulceration , erosion and nodal hyperplasia in the proximate jejunum consistent with crohn 's disease ( fig . 1a ) . neither the doctor nor the patient remembered finding the capsule in the stool . when the scope passed 20 cm from the treitz ligament we found jejunum erosion , nodal hyperplasia , stenosis ( fig . the dbe was inserted again for biopsy , and some specimen were retrieved . the next day , barium examination revealed that the stenosis was near to the treitz ligament ( fig . capsule retention is defined as the presence of the capsule endoscopy in the digestive tract for a minimum of 2 weeks after ingestion or the capsule being retained in the bowel lumen indefinitely unless a targeted medical , endoscopic , or surgical intervention is initiated . small bowel stenosis often leads to capsule retention . in this patient , we shared an examination process of a rare case of neuroendocrine malignant tumor in the small bowel . as the capsule endoscopy was stuck in the narrow parts , the lesion images from different angles were shot at different times , which led us to mistake for multiple lesions and to make a misdiagnosis of crohn 's disease . if we had adopted the therapeutic regimen in accordance to the diagnosis of crohn 's disease , maybe the patient would have lost the chance of operation . at the same time , we introduced the skills that the application of dbe could be used in the removal of capsule retention .
the diagnosis of neuroendocrine malignant tumor in the small bowel is difficult [ j oncol 2008;2008:212067 ] . 
 it is usually found intraoperatively during intestinal resection and confirmed by subsequent histological examination . 
 we reported a case of jejunum neoplasm which was misdiagnosed as crohn 's disease by capsule endoscopy . 
 capsule endoscopy was stuck in the jejunum stricture and was removed with a snare under double - balloon enteroscopy . 
 the pathology of the biopsy was jejunum small cell malignant carcinoma tending to neuroendocrine malignant tumor . 
 the immunohistochemical result revealed that cd99 and ki-67 were positive . 
 the patient underwent intestinal resection and the diagnosis of neuroendocrine malignant tumor was confirmed .