Duodeno-jejunal tumors. Report of 9 cases and literature review.
Nine patients with tumors of the duodenum and the jejunum are described herein and the Literature is reviewed. Of the six patients with a duodenal tumor, five had an adenocarcinoma and one a Brunner's gland adenoma. A predominance of inframpullary tumors was observed within the duodenum. Jaundice and abdominal pain were, respectively, the most common presenting symptoms of the tumors localized in the periampullary and inframpullary region. Treatment was curative in four and palliative in two cases. Duodenopancreatectomy was the treatment of choice for periampullary tumors whereas segmental resection was performed in the only resectable distal duodenal tumor. Of the three patients with jejunal neoplasms, one had an adenocarcinoma arising in the efferent loop of a Billroth II gastrojejunostomy performed 40 years before and two had an high malignant lymphoma. All three the tumors could be resected. According to the Literature, our results show that: 1. The diagnosis of duodeno-jejunal tumors is usually late: 2. Although of critical importance in the improvement of the overall diagnostic accuracy, endoscopy may be inconclusive or even misleading if the entire duodenum is not explored; 3. If duodenopancreatectomy is mandatory for periampullary tumors, segmental resection seems to be an adequate procedure for tumors of the distal duodenum since it does not ignore lymphatic nodes, can be easily performed and has a low postoperative complication rate.
Avallone
U
U
Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II.
De Blasio
R A
RA
Iannuzzi
C
C
Maione
P F
PF
Arciero
G
G
Negro
G
G
D000368:Aged; D000369:Aged, 80 and over; D004379:Duodenal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007580:Jejunal Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged