A CASE OF PRIMARY DUODENAL CARCINOMA DETECTED BY POSTCHOLECYSTECTOMIC SYMPTOM

Abstract

A case of primary duodenal carcinoma at the 4th portion was reprted, which was accidentally found by an obstinate abdominal pain after cholecystectomy. The case was a 45-year-old woman complaining of upper abdominal pain and back pain. Upper gastrointestinal series and endoscopy of the stomach revealed a scar after gastric ulcer. Ultrasonography of the abdomen which was carried out for the long-lasting symptoms showed cholecystic stones, and cholecystectomy was carried out. However, no symptomatic remission was attained after surgery, and she was diagnosed as postcholecystectomic symptom. It has passed 8 months when the repeated various examinations indicated a primary duodenal carcinoma at the 4th portion. She underwent pancreatoduodenectomy.
Carcinomas developed at distal-side of the duodenum usually have no characteristic clinical symptoms, and are possibly overlooked even by alimentary examinations of the upper gastrointestinal tract. When we encounter a case presenting with such symptoms as we can not reasonably explain in spite of some actual lesions detected on the gastrointestinal tract, a possible another lesion on the small intestine including duodenum should be remembered.