2022 Volume 55 Issue 11 Pages 692-700
An 85-year-old man was referred to our hospital due to frequent vomiting and abdominal pain. Abdominal CT revealed a jejunum tumor and small bowel obstruction. Laboratory tests showed elevated CA19-9 of 601.3 U/ml. Conservative treatment failed to improve the symptoms. Laparotomy identified an obstruction of the jejunum about 70 cm distal from Treitz’s ligament. Small bowel partial resection was performed, including the 5-cm tumor and dissected lymph nodes. Pathological examination revealed adenocarcinoma arising from a Heinrich type II aberrant pancreatic tumor in the jejunum. Radical resection was possible; however, two months after surgery, multiple liver metastases and intra-abdominal lymph node recurrence were found. The patient has since been treated with S-1. Aberrant pancreatic cancer in the small intestine is rare and difficult to diagnose preoperatively. We report this case with a review of the literature.
