十二指腸第４部癌の切除例

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  • A Resected Case of Primary Adenocarcinoma of the Fourth Portion of the Duodenum

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A 75-year-old man admitted for nausea and weight loss was found in upper gastrointestinal series and endo scopy to have a type-2tumor with stenosis at the fourth portion of the duodenum, diagnosed as moderately differentiated adenocarcinoma by endoscopic biopsy. Abdominal computed tomography (CT) showed an extremely irregular thick wall at the fourth portion of the duodenum but without invasion to adjacent vessels. We examined lymph nodes around the pancreas head by intraoperatively and partially resected the duode num and jejunum based on a diagnosis of negative swollen nodes and no macroscopic invasion toward the pancreas or proximal duodenal margin. The definitive diagnosis was primary adenocarcinoma of the fourth portion of the duodenum, T3, N0, M0, Stage II. We detail an extremely rare case of primary adenocarcinoma of the fourth portion of the duodenum and discuss surgical implications.

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