title: [A case of duodenal invasion due to recurrent gastric cancer with obstructive jaundice treated by chemotherapy].
abstract: A 64-year-old man was admitted to our hospital with complaints of jaundice, upper abdominal distension and pain. He had a history of laparoscopic-assisted distal gastrectomy for gastric cancer about 11 months ago. The stage was IB and pathological examination was poorly differentiated adenocarcinoma. The upper gastrointestinal fiberscope showed a continuous duodenal stenosis between an anastomotic region and the third portion. The pathological diagnosis was recurrent of gastric cancer. The abdominal CT scan showed a dilatation of bile duct due to duodenal invasion. After percutaneous transhepatic cholangio drainage (PTCD) and jejunotomy, the chemotherapy with low-dose CDDP and 5-FU followed by weekly paclitaxel was performed. The stenosis of duodenum and dilatation of bile duct were improved. The patient lived for 8 months after chemotherapy. It is important to understand that gastric cancer diagnosed poorly differentiated adenocarcinoma pathologically sometimes occurs duodenal invasion and obstructive jaundice.
authors.affiliation: Dept. of Surgery, Ube Industries Central Hospital.
authors.forename: Toru
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsukuma
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nagashima
authors.forename: Sakurao
authors.initials: S
authors.lastname: Hiraki
authors.forename: Shintaro
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D004379:Duodenal Neoplasms / Q000473:pathology; D004380:Duodenal Obstruction / Q000209:etiology; D004386:Duodenum / Q000473:pathology*; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D007409:Intestinal Atresia; D041781:Jaundice, Obstructive / Q000209:etiology*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D017239:Paclitaxel / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil