Paskan J, Prochotský A, Cerný J, Valach G
Chirurgická klinika NsP Bezrucova 5 v Bratislave, Slovakia.
Bratisl Lek Listy. 1993 Oct;94(10):551-4.
The authors report the case of a 48 year old patient with duodenal adenocarcinoma. The patient was hospitalized at the internal clinic and due to massive bleeding into GIT was removed into the surgical clinic in a state of shock. The operation revealed a Tu formation on the border between D3 and D4, and a palliative resection was performed. The histologic examination verified the diagnosis of the duodenal carcinoma, WHO gr.II. During the postoperative period the patient received 4 chemotherapeutic treatments, although literature generally refers to chemotherapy as having no effect on the time of survival in patients with duodenal adenocarcinoma. The authors conclude that in patients with a long termed history of atypical abdominal symptoms including bleeding into GIT which are inexplicable owing to fibroscopy and x-ray, it is necessary to take into consideration the possible presence of neoplasms in the small intestine, and hence in the duodenum. In cases with massive bleeding they recommend palliative resection and subsequent chemotherapy. (Fig. 6, Ref. 11.).
作者报告了一例48岁十二指肠腺癌患者的病例。该患者在内科诊所住院，由于胃肠道大量出血，在休克状态下被转入外科诊所。手术发现十二指肠第三部（D3）和第四部（D4）交界处有一个肿瘤形成，并进行了姑息性切除。组织学检查证实为十二指肠癌，世界卫生组织（WHO）二级。术后患者接受了4次化疗，尽管文献普遍认为化疗对十二指肠腺癌患者的生存时间没有影响。作者得出结论，对于有长期非典型腹部症状病史（包括胃肠道出血）且经纤维内镜检查和X光检查无法解释的患者，有必要考虑小肠乃至十二指肠可能存在肿瘤。对于大量出血的病例，他们建议进行姑息性切除并随后进行化疗。（图6，参考文献11）
