Tsai C J
Dept. of Internal Medicine, Chi Mei Foundation Hospital, Yung Kang City, Tainan, Taiwan.
Scand J Gastroenterol. 1994 Oct;29(10):930-3. doi: 10.3109/00365529409094865.
Primary adenocarcinoma of the duodenum is an uncommon clinical entity. It has been associated with a dismal prognosis because it is rare and produces no distinctive symptoms until late in its course.
A 68-year-old man presented with a 6-month history of epigastralgia, anorexia, and progressive weight loss. Esophagogastroduodenoscopy showed a tumor mass in the deformed duodenal bulb with a fistula into the biliary tract. Upper gastrointestinal (UGI) barium studies and cholangiography confirmed a fistulous communication between the duodenum and biliary tree.
Aggressive evaluation of minor, yet refractory, UGI symptoms and a high index of suspicion offer the best hope for early diagnosis. Esophagogastroduodenoscopy and barium UGI study are the principal methods of diagnosis of these tumors. Early diagnosis would thus prevent metastasis and complications.
十二指肠原发性腺癌是一种不常见的临床病症。因其罕见且在病程晚期才出现无特异性的症状，故其预后通常较差。
一名68岁男性，有6个月上腹部疼痛、厌食及进行性体重减轻的病史。食管胃十二指肠镜检查显示十二指肠球部变形处有一肿瘤肿块，并伴有通向胆道的瘘管形成。上消化道（UGI）钡剂造影及胆管造影证实十二指肠与胆道系统之间存在瘘管相通。
对于轻微但难治的上消化道症状进行积极评估并保持高度怀疑指数，是实现早期诊断的最大希望。食管胃十二指肠镜检查及上消化道钡剂造影是诊断这些肿瘤的主要方法。早期诊断可预防转移及并发症的发生。
