Abstract
We described a case of the proximal jejunal cancer diagnosed with transnasal EGD. 55-year old Japanese woman visited to our department with complaining nausea and appetite loss. The plain abdominal X ray and CT showed fullness of the stomach, dilatation of the duodenum and stricture of the proximal jejunum. We performed transnasal EGD without sedation. After gastroduodenal observation, when we inserted a super stiff guide wire into the biopsy channel until 20cm distal end of the scope, we were able to advance the scope until the proximal jejunum. We pointed out the near-circumferential mass like type 2 in about 5 cm anal side from duodenojejunal junction. We diagnosed it as the jejunal adenocarcinoma with biopsy. Since it is not easy to observe the distal duodenum and the proximal jejunum with a conventional upper gastrointestinal endoscopy, we often need to use a capsule endoscopy or balloon endoscopy. However, we were able to diagnose the lesion with only transnasal EGD by a little ingenuity.
