Adenocarcinoma of Duodenum at the Duodenojejunal Flexure

Abstract

Adenocarcinoma of the duodenum is an exceedingly rare condition representing not more than 0.3% to 0.4% of all gastrointestinal tract cancers. Clinical presentation is usually due to partial or complete obstruction of the duodenum. Computed tomography scan has a high accuracy in detecting metastatic spread to stage the disease. CASE REPORT: A 60 year woman presented with chief complaints of persistent bilious projectile vomiting containing undigested food material and pain in the upper abdomen since 6 months. Upper gastrointestinal endoscopy up to 2 nd part of duodenum revealed no abnormality. Contrast enhanced computed tomography (CECT) scan of abdomen showed a dilated stomach and duodenal dilatation up to 4 th part along with a concentric growth seen in the fourth part of duodenum at the duodenojejunal flexure, and multiple retroperitoneal lymph-adenopathy. Exploratory laparotomy revealed a tumor of the duodenojejunal flexure with dilatation of all the parts of duodenum and stomach. The tumor was seen encasing the superior mesenteric vessels and aorta. A palliative gastro-jejunostomy was performed. Patient had an attack of acute myocardial infarction on post-operative day 6th and expired. Histopathology of the specimen confirmed adenocarcinoma of duodenum. CONCLUSIONS: Adenocarcinoma of duodenojejunal flexure is extremely rare and sometimes difficult to diagnose. Computed tomography scan has a high accuracy in detecting the disease and its metastatic spread to stage the disease. For unresectable tumors, palliative gastro-jejunostomy is the treatment of choice.

A rare case report on Intraductal papilloma of nipple in a young female – radiographical and histopathological correlation

“…A study byRoy et al, (1985) reported a giant intraductal papilloma which presented as 15cm nipple mass. A study byShih et al, (2020) reported two cases of intraductal papilloma of nipple which were confirmed by histopathological examination(Sahu et al, 2012;Mesurolle et al, 2006).…”

Constraints Faced by the Paddy Growers in Adoption of Recommended Paddy Production Practices in Budgam District of Kashmir

“…Also more than one fourth of the farmers faced the problem of seeds available are of substandard. et al, (2003), Rai et al, (2013), Ram et al, (2009) and Sahu et al, (2009). The member farmers had number of problems pertaining to Paddy Production.…”