Watatani M, Yasuda N, Imamoto H, Tamura K, Mori I, Hara T
Department of Surgery, Kawachi General Hospital, Higashi Osaka, Japan.
Gastroenterol Jpn. 1989 Aug;24(4):402-6. doi: 10.1007/BF02774347.
Progress in diagnostic procedures has made it possible to diagnose neoplasms of the gastrointestinal tract preoperatively. However, preoperative diagnosis of tumors of the small intestine remains difficult. We report here detection of an adenocarcinoma of the jejunum by endoscopic examination prior to operation. A 73-year-old woman was admitted with complaints of intermittent periumbilical pain, nausea, and vomiting. An upper gastrointestinal series showed an abnormal segmet 10 cm distal to the duodenojejunal flexure. Small intestinal endoscopic examination revealed a tumor with a crater and an irregular surface of mucosa near the duodenojejunal flexure, and annular constriction due to tumor extension, and endoscopic biopsy specimens contained tissue from a poorly differentiated adenocarcinoma. Wide resection, including the duodenum, proximal jejunum, and adjacent mesentery was performed. The resected tumor was confirmed histologically to be a poorly differentiated adenocarcinoma of the jejunum.
诊断程序的进展使得术前诊断胃肠道肿瘤成为可能。然而，小肠肿瘤的术前诊断仍然困难。我们在此报告一例术前通过内镜检查发现的空肠腺癌。一名73岁女性因间歇性脐周疼痛、恶心和呕吐入院。上消化道造影显示十二指肠空肠曲远端10 cm处有一段异常。小肠内镜检查发现十二指肠空肠曲附近有一个有溃疡和不规则黏膜表面的肿瘤，以及因肿瘤扩展导致的环形狭窄，内镜活检标本包含低分化腺癌组织。进行了包括十二指肠、空肠近端和相邻肠系膜的广泛切除。切除的肿瘤经组织学证实为空肠低分化腺癌。
