Rajurkar Vaishnavi D, Chauhan Lokesh Singh, Barole Nisha D, Sagar Shakti
Pathology, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Sep 7;16(9):e68915. doi: 10.7759/cureus.68915. eCollection 2024 Sep.
Gastrointestinal malignancies, most specifically duodenal malignancy, are uncommon in the population; however, they are tricky to manage because the lesions are diagnosed at a late stage and located in a complex area. This case report focuses on a patient who was diagnosed with a second (descending) part of the duodenum (D2) malignancy; the tumour was localised at the second part of the duodenum, and the management of this patient was through the Whipple procedure or pancreaticoduodenectomy. The patient complained of stinging abdomen pain. Diagnostic examination comprised of CT and biopsy proved the presence of a malignant tumour originating from the D2 area. The tumour's characteristics and the patient's general health status are determined by using Whipple's procedure. Post-operative management entails the use of IV antibiotics, analgesics, multivitamins and nasojejunal (NJ) tube feeding. The case also expounds on the consequences of a multimodal treatment strategy, meticulous planning of the surgical procedure, and adequate post-operative management of D2 malignancies. These data may shed some light on the peculiarities of duodenal cancer management with the Whipple procedure; nonetheless, early diagnosis and proper management should remain the primary goals.
胃肠道恶性肿瘤，尤其是十二指肠恶性肿瘤，在人群中并不常见；然而，由于病变在晚期才被诊断出来且位于复杂区域，所以治疗起来很棘手。本病例报告聚焦于一名被诊断为十二指肠（D2）降部恶性肿瘤的患者；肿瘤位于十二指肠降部，对该患者的治疗采用了惠普尔手术或胰十二指肠切除术。患者主诉腹部刺痛。诊断性检查包括CT和活检，证实存在起源于D2区域的恶性肿瘤。通过惠普尔手术确定肿瘤特征和患者的一般健康状况。术后管理包括使用静脉抗生素、镇痛药、多种维生素和鼻空肠（NJ）管饲。该病例还阐述了多模式治疗策略、手术程序的精心规划以及D2恶性肿瘤术后充分管理的后果。这些数据可能会揭示惠普尔手术治疗十二指肠癌的特点；尽管如此，早期诊断和恰当治疗仍应是首要目标。
