Duodenal Pyloric Gland Adenoma (PGA) with Invagination into the Jejunum—A Case Report—

Abstract

A 71-year-old man presented to our hospital with vomiting and fever and was immediately admitted because of severe anemia. On endoscopy, a polyp-like tumor stuck to the jejunum beyond the ligament of Treitz was observed ; it was diagnosed as invagination of a duodenal tumor, and surgery was performed. During surgery, the tumor was identified in the jejunum, 20 cm distal to the ligament of Treitz. Due to the large size of the tumor and the difficulty of returning it manually, the jejunum was incised, and the tumor was excised at its base. Intraoperative endoscopy confirmed the base of the tumor in the duodenum on the lesser curvature side, and a partial resection of the duodenal wall was performed. The patient's postoperative course was uneventful. He was discharged on the 17th postoperative day. On histopathological examination, the diagnosis of the 90-mm tumor was pyloric gland adenoma. No recurrence of tumor was evident at 12-month follow-up.

Tumors arising from the duodenal bulb rarely invaginate beyond the ligament of Treitz into the jejunum.