Carcinoma of the small intestine is comparatively rare. A 29-year-old man was admitted to the hospital because of vomiting and left abdominal pain. Iieus was suspected by a scout film of the abdomen. Small intestinal barium meal examination revealed a Borrmann type 2 elevated lesion.
The endoscopy of small intestine using push way style fiberscope (Olympus SIF10) was performed and biopsy was done. But, biopsy was negative. Operation was done on 20th hospital day. The tumor was located in the jejunum anally about 140 cm from the ligament of Treitz. The resected specimen showed well differentiated papillotubular adenocarcinoma of the jejunum, 2.5 by 2.0 by 1.0cm in size. But, the dissemination to the vesicorectal pouch and mesenteric lymphnodes were diagnosed at operation and finally confirmed by pathological examination.
In Japan, push way style small intestinal fiberscope is widely employed rather than ropeway and sonde method. In the literature, 58 cases are reported for various small intestinal diseases until now. Our case is the deepest one which is observed successfully by endoscopy. This technic is very useful for the preoperative evaluation of the small intestinal mass.
