A CASE OF PRIMARY DUODENAL CANCER OF THE HORIZONTAL PORTION AFTER BILLROTH II RECONSTRUCTION

Abstract

Twenty five years after a Billroth II (B-II) procedure for an advanced gastric cancer, a 75-year-old man was referred for persistent abdominal pain and progressive anemia. Abdominal CT and small-caliber colonoscopy revealed advanced primary duodenal cancer of the horizontal portion. Although radical surgery was proposed, it was converted to exploratory surgery due to advanced permeation of the cancer. Positive examination of the afferent loop is necessary, if persistent abdominal pain or gastrointestinal bleeding occurs after a gastrectomy with B-IIor Roux-Y reconstruction.