Abstract
A 69-year-old male was admitted to our hospital for abdominal pain and diarrhea, and subsequent laboratory examination revealed the presence of severe anemia. Gastrointestinal fiberscopy revealed a mass associated with a deep ulcer in the second portion of the duodenum which was subsequently diagnosed as adenocarcinoma on endoscopic guided biopsy. Upper gastrointestinal series revealed a fistula between the duodenum and the colon, and the patient was referred to our department for surgery. Pancreaticoduodenectomy and right hemicolectomy were subsequently performed. No foci of carcinoma metastasis were detected in the regional lymph nodes of the colon with an exception of the superior lymph node on the posterior surface of the pancreatic head in which small focus of adenocarcinoma metastasis was detected. There have been no clinical signs of recurrence and the patient is alive without disease as of 8 years and 10 months after the operation. Long-term survival of the patients may be feasible providing that en block resection including lymph node dissection is performed.
