Department of Surgery, Hakodate Medical Association Hospital, 10-10 Tomioka-cho, Hakodate, Hokkaido, Japan.
Surg Today. 2012 Jun;42(6):605-9. doi: 10.1007/s00595-012-0125-9. Epub 2012 Jan 27.
An 84-year-old male was admitted to a local clinic suffering from general fatigue with associated anemia, and therefore was referred to our hospital. His medical history included a proximal gastrectomy with the formation of a jejunal pouch as a reconstructive treatment for early upper gastric cancer at 78 years of age (6 years prior). A type 2 tumor located in the jejunal pouch almost completely surrounded by small intestinal mucosa was demonstrated by gastrointestinal endoscopy. The biopsy specimens showed a moderately differentiated tubular adenocarcinoma. Computed tomography showed no lymphadenopathy or hepatic metastases. A resection of the residual stomach and jejunal pouch was performed. Based on the histological findings from the resected specimen, the tumor was considered to be primary adenocarcinoma in the jejunal pouch. The postoperative course was uneventful, and the patient has shown no evidence of any recurrence during the 6-year period after the most recent surgery.
一位 84 岁男性因全身乏力伴贫血至当地诊所就诊，遂转至我院。患者病史包括 78 岁时（6 年前）因早期胃上部癌行近端胃切除术并形成空肠袋作为重建治疗。胃肠内镜检查显示空肠袋内有一个 2 型肿瘤，几乎完全被小肠黏膜包围。活检标本显示中分化管状腺癌。计算机断层扫描未显示淋巴结病或肝转移。行残胃和空肠袋切除术。根据切除标本的组织学发现，肿瘤被认为是空肠袋原发性腺癌。术后恢复顺利，患者在最近一次手术后的 6 年期间未出现任何复发迹象。
